Severe late dysphagia and cause of death after concurrent chemoradiation for larynx cancer in patients eligible for RTOG 91-11

Ward, Matthew C.; Adelstein, David J.; Bhateja, Priyanka; Nwizu, T.; Scharpf, Joseph; Houston, N.; Lamarre, Eric; Lorenz, Robert R.; Burkey, Brian B.; Greskovich, J.F.; Koyfman, Shlomo A.

doi:10.1016/j.oraloncology.2016.03.014

Cited by 29 publications

(23 citation statements)

References 11 publications

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“…21 Ward et al further investigated this theory and found that severe late dysphagia was not contributing to these mortalities, but medical comorbidities are a fundamental component of survivorship care. 25 The findings of our study suggest that the outcomes in this group are likely explained by a combination of complex inter-related factors that are patient-specific, rather than related to the primary tumor itself.…”

Section: Discussionmentioning

confidence: 65%

Survival Outcomes in Patients with T2N0M0 (Stage II) Squamous Cell Carcinoma of the Larynx

Gainor

Marchiano

Bellile

et al. 2017

Otolaryngol.--head neck surg.

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Objective Emerging data have demonstrated suboptimal outcomes among patients with stage II larynx cancer. Our objective is to report survival outcomes for T2N0M0 larynx cancer, and to determine the cause-specific survival. Study Design Case series with planned data collection. Setting Tertiary academic center. Subjects Adults with T2N0M0 squamous cell carcinoma of the larynx treated with curative intent. Methods A head and neck cancer epidemiology database was queried for eligible subjects from 2003-2014. Data were extracted from the electronic medical record and research database and survival analyses were performed. Results Thirty-four patients with previously-untreated stage II larynx cancer were identified (median follow-up 48 months). Patients included 27 males and 7 females with a mean age of 59 years. The majority of tumors arose from the glottis (59%). Of the cohort, 12% were treated with surgery, 65% radiation therapy, and 24% chemoradiation therapy. The estimated two-year overall survival was 81%, (95% CI, 59%-92%), disease-specific survival was 91%, (95% CI, 69%-98%), and recurrence-free survival was 84%, (95% CI, 65%-93%). Four out of 5 patients with persistent or recurrent disease post-treatment were successfully salvaged with total laryngectomy with 100% locoregional control. There were 11 mortalities (two disease related, two due to metachronous primaries, three treatment related, and four from other/unknown causes). Conclusion Stage II laryngeal cancer has suboptimal survival outcomes. This appears to be a reflection of medical comorbidities, propensity for metachronous primaries, and the sequelae of late treatment effects rather than poor locoregional control.

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Section: Discussionmentioning

confidence: 65%

Survival Outcomes in Patients with T2N0M0 (Stage II) Squamous Cell Carcinoma of the Larynx

Gainor

Marchiano

Bellile

et al. 2017

Otolaryngol.--head neck surg.

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“…Caudell et al reported a 3‐year laryngoesophageal dysfunction‐free survival of 29% among patients treated by larynx preservation for locally advanced cancers of the larynx and hypopharynx. Ward et al similarly documented a 5‐year incidence of severe late dysphagia of 27% among 84 patients with locally advanced laryngeal cancer treated by chemoradiotherapy. Lambert et al showed that 23% of patients underwent significant long‐term toxicity after chemoradiotherapy for locally advanced laryngeal and hypopharyngeal cancer.…”

Section: Discussionmentioning

confidence: 98%

Effect of daily fraction size on laryngoesophageal dysfunction after chemoradiation for squamous cell carcinomas of the larynx and hypopharynx

et al. 2017

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“…In a series of 84 LC patients treated by CRT, Ward et al showed a rate of severe late dysphagia of 26.5%, with 8 (10%) patients requiring permanent enteral nutrition [41]. Interestingly, five of the eight feeding-tube insertions occurred beyond five years after CRT, thus highlighting the long-term side effects of CRT on larynx functions [41]. In a retrospective chart review of 477 patients undergoing curatively intended treatment for LC, Anschuetz et al found a 5% rate of feeding-tube dependence at the last follow-up in patients receiving primary CRT [42].…”

Section: Total Laryngectomy As a Functional Surgical Proceduresmentioning

confidence: 99%

“…The rate of definitive enteral nutrition in patients included in an LP program is around 5%-10% [13]. In a series of 84 LC patients treated by CRT, Ward et al showed a rate of severe late dysphagia of 26.5%, with 8 (10%) patients requiring permanent enteral nutrition [41]. Interestingly, five of the eight feeding-tube insertions occurred beyond five years after CRT, thus highlighting the long-term side effects of CRT on larynx functions [41].…”

Section: Total Laryngectomy As a Functional Surgical Proceduresmentioning

confidence: 99%

Current Role of Total Laryngectomy in the Era of Organ Preservation

Bozec

Culié

Poissonnet

et al. 2020

Cancers

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In this article, we aimed to discuss the role of total laryngectomy (TL) in the management of patients with larynx cancer (LC) in the era of organ preservation. Before the 1990s, TL followed by radiotherapy (RT) was the standard treatment for patients with locally advanced LC. Over the last 30 years, various types of larynx preservation (LP) programs associating induction or concurrent chemotherapy (CT) with RT have been developed, with the aim of treating locally advanced LC patients while preserving the larynx and its functions. Overall, more than two-thirds of patients included in a LP program will not require total laryngectomy (TL) and will preserve a functional larynx. However, despite these advances, the larynx is the only tumor site in the upper aero-digestive tract for which prognosis has not improved during recent decades. Indeed, none of these LP protocols have shown any survival advantage compared to primary radical surgery, and it appears that certain LC patients do not benefit from an LP program. This is the case for patients with T4a LC (extra-laryngeal tumor extension through the thyroid cartilage) or with poor pretreatment laryngeal function and for whom primary TL is still the preferred therapeutic option. Moreover, TL is the standard salvage therapy for patients with recurrent tumor after an LP protocol.

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Severe late dysphagia and cause of death after concurrent chemoradiation for larynx cancer in patients eligible for RTOG 91-11

Cited by 29 publications

References 11 publications

Survival Outcomes in Patients with T2N0M0 (Stage II) Squamous Cell Carcinoma of the Larynx

Survival Outcomes in Patients with T2N0M0 (Stage II) Squamous Cell Carcinoma of the Larynx

Effect of daily fraction size on laryngoesophageal dysfunction after chemoradiation for squamous cell carcinomas of the larynx and hypopharynx

Current Role of Total Laryngectomy in the Era of Organ Preservation

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