Radiation treatment of glottic squamous cell carcinoma, stage I and II: Analysis of factors affecting prognosis

Franchin, Giovanni; Minatel, Emilio; Gobitti, Carlo; Talamini, Renato; Sartor, G.; Caruso, Giuseppe; Grando, Giuseppe; Politi, Doriano; Gigante, Marco; Toffoli, Giuseppe; Trovò, M.; Barzan, Luigi

doi:10.1016/s0360-3016(97)00768-2

Cited by 36 publications

(23 citation statements)

References 22 publications

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“…In 246 T 1 -T 2 patients, the 5-year survival was 83% after radiotherapy. The same study concludes that good general condition (< 80 years of age) and exophytic tumors were the best candidates for radiotherapy [11]. Finally a third group of studies strongly suggests surgery for T 1 glottic carcinomas, either by microlaryngoscopy such as Zeitels [36] or with the use of the laser such as Remacle et al [26], or with vertical hemilaryngectomy such as Sheen et al [29] suggests, presenting a 5-year survival rate of the order of 97.4%.…”

Section: Discussionmentioning

confidence: 71%

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

Markou

Nikolaou

Nalbadian

et al. 2002

European Archives of Oto-Rhino-Laryngology

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Between 1992 and 1998, 547 patients (pts) with laryngeal SCC were diagnosed and treated in our department, 145 (27%) of whom presented with glottic tumors T1N0M0 (125 T1a and 20 T1b). Seventy-eight (54%) were treated surgically with cordectomy and 67 (46%) with radiotherapy. After a median follow-up time of 43 months, 22 (15.2%) of the 145 pts presented with recurrent disease. In more detail, 16 (13%) of the 125 T1a pts and 6 (30%) of the 20 T1b pts had recurrences. Among the 78 surgically treated patients only 4 (5%) had recurrence, while 18 (27%) of the radiotherapy group relapsed. The difference is statistically significant (log rank test, P = 0.0001 < 0.05). After salvage treatment, of the 67 pts of the radiotherapy group 57 (85%) remain disease-free, 49 (73%) retaining their larynx intact and 1 only having undergone cordectomy. Among the cordectomy group 75 (96%) pts remain disease-free with only 1 having had a total laryngectomy. Using the Kaplan-Meier method and calculating the disease-free survival regardless of salvage treatment, there is no doubt that surgical treatment statistically is more successful than radiotherapy (log rank test, P = 0.01 < 0.05). Analysis of parameters such as tumor differentiation and T1a or T1b staging, which indeed influence the overall recurrence rate, did not alter the favorable outcome after surgical treatment.

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Section: Discussionmentioning

confidence: 71%

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

Markou

Nikolaou

Nalbadian

et al. 2002

European Archives of Oto-Rhino-Laryngology

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“…Salvage treatment for those patients consisted of surgery in five, curative RT in four, chemotherapy in one, and palliative treatment in four patients. Discussion RT is widely used as a primary modality in the treatment of early glottic cancer [20,24,34,54,62]. Both RT and conservative surgery, i.e., cordectomy, laser microsurgery or partial laryngectomy, seem to be equally effective modalities in terms of local control and survival [55,57] although not confirmed by any randomized comparison.…”

Section: Resultsmentioning

confidence: 99%

“…Numerous reports regarding the treatment of early glottic cancer have evaluated a number of prognostic factors, i.e., tumor volume and stage [20,28,37], tumor kinetics including p53 status [3,13,48], histological differentiation, intrinsic radiosensitivity [28], smoking habits and hypoxia [9], pretreatment hemoglobin level [14,59,69], dose per fraction [70], total dose [62], overall treatment time [4,10,18,27,52,53,58], field size [64], beam energy [16,19], radiation technique [61], and anterior commissure involvement [41,51]. These factors were not always reported to have a prognostic influence by all authors [17,30,46,66,67].…”

Section: Resultsmentioning

confidence: 99%

Decreased Local Control Following Radiation Therapy Alone in Early-Stage Glottic Carcinoma with Anterior Commissure Extension*

et al. 2004

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“…2 Definitive radiation therapy is the mainstay of treatment for early stage disease (T1-2 N0), which accounts for 50% to 60% of reported cases of laryngeal cancer. 3,4 The goals of treatment for early laryngeal cancer are cure and voice preservation. 5 Five-year local recurrence rates for T1 lesions are 5% to 20%, accounting for the primary cause of failure in these patients.…”

mentioning

confidence: 99%

Prognostic significance of vascular endothelial growth factor protein levels in T1‐2 N0 laryngeal cancer treated with primary radiation therapy

Yang¹,

Haffty²

2006

Cancer

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BACKGROUND.The purpose of this study was to assess the prognostic value of vascular endothelial growth factor protein levels in a large cohort of patients with T1‐T2 N0 laryngeal cancer treated with primary radiation therapy (XRT).METHODS.Primary tumor specimens from a cohort of 123 patients with T1‐T2 N0 laryngeal cancer treated with XRT between 1975 and 2000 were constructed into a tissue microarray. Clinical prognostic factors included age, sex, T classification, and tumor subsite. Molecular prognostic factors included vascular endothelial growth factor, epidermal growth factor receptor, and p53 expression, determined by using immunohistochemistry on tissue microarrays. The association between vascular endothelial growth factor status, covariables, and outcome was assessed.RESULTS.With a median follow‐up of 9.9 years, 32 (26%) were diagnosed with local relapse (5‐year local relapse‐free rate, 70.4%). T2 tumor stage (31.7%) was a significant predictor of local relapse (relative risk [RR], 1.71; 95% confidence interval [CI], 1.21–2.43; P<.05). Positive expression of vascular endothelial growth factor, epidermal growth factor receptor, and p53 were: 8.5%, 58.7%, and 36.4%, respectively. In univariate analysis, vascular endothelial growth factor positivity was a significant predictor of overall survival (RR = 1.62; 95% CI, 0.99–2.42; P = .05). In multivariate analysis, positive vascular endothelial growth factor status maintained significant correlation with overall survival (RR, 2.79; 95% CI, 1.49–4.95; P = .002).CONCLUSIONS.Vascular endothelial growth factor positivity appeared to be a significant predictor of overall survival in a multivariate model. Further evaluation of vascular endothelial growth factor‐positive laryngeal cancers treated with primary XRT is warranted. Cancer 2007;109:566–573. © 2006 American Cancer Society.

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Radiation treatment of glottic squamous cell carcinoma, stage I and II: Analysis of factors affecting prognosis

Cited by 36 publications

References 22 publications

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

Decreased Local Control Following Radiation Therapy Alone in Early-Stage Glottic Carcinoma with Anterior Commissure Extension*

Prognostic significance of vascular endothelial growth factor protein levels in T1‐2 N0 laryngeal cancer treated with primary radiation therapy

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