Radiotherapy in the treatment of T3‐T4 supraglottic tumors

Henry, J; Balikdjian, Daniel; Storme, Guy; Lustman‐Maréachal, J.; Degandt, Jean Baptiste

doi:10.1288/00005537-197510000-00007

Cited by 2 publications

(1 citation statement)

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“…24 Table 4 summarizes selected outcomes of RT whether in the postoperative or the definitive setting for the treatment of patients with T4 laryngeal cancer as reported in the literature. 18,22,23,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] Despite advances in imaging, radiation planning and delivery, and combining chemotherapy with RT, nonsurgical LP efforts must be evaluated carefully within the context of functional integrity and disease control. Issues to be considered include freedom from aspiration (which to our knowledge is rarely evaluated or reported in the literature), the need for tracheostomy and feeding tubes or dietary modifications, voice intelligibility, the potential for salvage surgery for failures after RT, and locoregional RFS compared with initial laryngectomy.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: A 3‐decade survey

Rosenthal

Mohamed

Weber

et al. 2015

Cancer

112

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BACKGROUND To evaluate long-term disease control, survival, and functional outcomes after surgical and nonsurgical initial treatment for T4 larynx cancer. METHODS Demographics, disease stage, and treatment characteristics were reviewed for 221 sequential patients treated for T4 laryngeal squamous cell cancer at a single institution between 1983-2011. Survival and disease-control outcomes were calculated. RESULTS The median follow-up time was 47 months (71 months for patients alive at the time of analysis). The overall 5- and 10-year overall survival (OS) rates were 52% and 29%, and the corresponding disease free survival rates were 57% and 48%. Overall 5- and 10-year locoregional control (LRC) was 78% and 67% and freedom from distant metastasis 76% and 74%. In both univariate and multivariate analyses, node-positive disease at presentation was associated with overall mortality, (P<0.0001). Patients treated by laryngectomy followed by post-laryngectomy radiotherapy (161 patients) achieved better initial LRC than patients treated by a laryngeal preservation (LP) approach (60 patients) throughout the follow-up period (log-rank P<0.007) yet median OS times were equal (64 months) for both groups (95% confidence interval [CI] 47-87 months, and 38-87 months, respectively, P=0.7) LP Patients had a tracheostomy rate of 45% and any-event aspiration rate of 23%. Rates of high-grade dysphagia at last follow-up were worse for LP patients (P<0.01). CONCLUSIONS Surgery and postoperative RT can produce substantial long-term cancer control and survival rates for patients with T4 larynx cancer. Caution should be taken in selecting patients for initial nonsurgical treatment because of significant rates of functional impairment despite survival equivalence.

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