1
|
Shneyderman M, Shen S, Tanavde V, Kut C, Kiess AP, Naunheim MR, Akst LM. Factors Impacting Provider Treatment Decision-Making in Early Glottic Cancer. Laryngoscope 2024; 134:3686-3694. [PMID: 38727258 DOI: 10.1002/lary.31494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/17/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES Transoral laser microsurgery (TLMS) and radiotherapy (XRT) are mainstays of treatment for early glottic carcinoma (EGC). Here, we investigated case-dependent provider treatment preferences and identify factors which impact decision-making in EGC. METHODS This cross-sectional survey of laryngologists, head-and-neck surgeons, and radiation oncologists presented five diagrammatic cases of progressively advanced EGC (T1/2, N0). Respondents indicated preference for TLMS or XRT and ranked factors which influenced their recommendation for each case. Analysis utilized descriptive statistics, Fischer's exact tests, and Kruskal-Wallis tests for nonparametric data. RESULTS A total of 141 complete responses (69.5% laryngologists) were received. Most respondents practiced in academic settings (93.5%) and within multidisciplinary teams (94.0%). Anterior commissure involvement was the most important a priori tumor factor for case-independent treatment recommendation (Likert Scale: 4.22/5), followed by Laterality (Likert Scale: 4.02/5). Across all specialties, TLMS was recommended for unilateral T1a lesions. Laryngologists continued recommending TLMS in T2 lesions (41.0%) more than head-and-neck surgeons (5.0%) and radiation oncologists (0.0%). Across all cases, survival and voice outcomes were the most important clinical factors impacting treatment decisions. Radiation oncologists weighed voice more heavily than laryngologists in more complex presentations of EGC (rank: 1.6 vs. 2.7, Kruskall-Wallis: p < 0.05). CONCLUSIONS In more complex clinical presentations of EGC, preference for TLMS compared to XRT differed across specialists, despite similar rankings of factors driving these treatment recommendations. This may be driven by differing experiences and viewpoints on case-dependent voice outcomes following TLMS versus XRT, suggesting a need for increased understanding of how tumor location and depth impact voice outcomes. LEVEL OF EVIDENCE 5 Laryngoscope, 134:3686-3694, 2024.
Collapse
Affiliation(s)
- Matthew Shneyderman
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Sarek Shen
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Ved Tanavde
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Carmen Kut
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Ana P Kiess
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Matthew R Naunheim
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | - Lee M Akst
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| |
Collapse
|
2
|
Dagan O, Perlow A, Shoffel-Havakuk H, Biadsee A, Moore A, Ritter A, Gilat H, Popovtzer A, Alkan U. Effect of Radiological Tumor Thickness on Prognosis of Early Glottic-Squamous Cell Carcinoma Treated With Radiation. J Voice 2024:S0892-1997(24)00056-0. [PMID: 38570226 DOI: 10.1016/j.jvoice.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Tumor depth of invasion is a known prognostic factor in several head and neck cancers, but data on early laryngeal squamous cell carcinoma (SCC) are sparse. In this study, we aim to determine whether radiological tumor thickness serves as a prognostic factor in early SCC of the glottis treated with radiation. METHODS One hundred thirty-two adult patients (age >18 years) underwent pretreatment computed tomography (CT) and were treated with radiation for pathologically proven early stage (T1 or T2) glottic SCC. Thirty-eight were excluded because the tumor could not be correctly identified on the CT scan, and an additional three patients because of insufficient data. RESULTS The final cohort consisted of 91 patients, 84 (90.3%) men and 7 (9.7%) women aged 39.86-86.53 (mean 65.55 ± 12.76) years. Mean tumor thickness was 0.59 ± 0.19 cm in patients with T1 tumors and 0.79 ± 0.21 cm in patients with T2 tumors. The optimal cutoff value for 5-year disease-free survival (DFS), using the Youden index (sensitivity: 81.2%, specificity 65.3%), was 0.7 cm. A significant advantage in 5-year overall survival (OAS) and 5-year DFS for tumor thickness of <0.7 cm (P = 0.01 and P < 0.01, respectively) was found, these findings were consistent also when each stage was examined separately (T1 vs T2). CONCLUSION Radiological tumor thickness appears to significantly predict OAS and DFS in early glottic SCC patients. IMPLICATION FOR PRACTICE Tumor thickness may be considered as an auxiliary aid in deciding follow-up time and frequency, proper treatment, and determining prognosis.
Collapse
Affiliation(s)
- Or Dagan
- Department of Dermatology and Venereology, Soroka Medical Center, Be'er Sheva, Israel
| | - Alain Perlow
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Radiology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Hagit Shoffel-Havakuk
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Ameen Biadsee
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Otorhinolaryngology-Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel
| | - Assaf Moore
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rabin Medical Center, Davidoff Cancer Center, Petah Tikva, Israel
| | - Amit Ritter
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Hanna Gilat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Aron Popovtzer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rabin Medical Center, Davidoff Cancer Center, Petah Tikva, Israel
| | - Uri Alkan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel.
| |
Collapse
|
3
|
Rigal T, Baudouin R, Circiu M, Couineau F, Lechien J, Crevier‐Buchman L, Le Guen M, Hans S. Laryngeal microsurgery under Transnasal Humidified Rapid Insufflation Ventilatory Exchange. OTO Open 2024; 8:e125. [PMID: 38863485 PMCID: PMC11165682 DOI: 10.1002/oto2.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 01/27/2024] [Indexed: 06/13/2024] Open
Abstract
Objective Since 2015, Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) has been used in general anesthesia for preoxygenation or difficult exposure airway management. Its use offers new opportunities in laryngology. THRIVE increases apnea time and frees the access to the upper airway. However, its use may be less stable than orotracheal intubation. The main objective of this work was to evaluate the feasibility of laryngeal microsurgery under THRIVE including using Laser. Study Design Retrospective. Setting A total of N = 99 patients with laryngeal microsurgery (with or without CO2 laser) under THRIVE were included successively from January 1, 2020 to January 30, 2022. Method Medical history, comorbidities, clinical and surgical data were extracted and analyzed. Two groups were constituted regarding the "success" (use of THRIVE along all the procedure) or the "failure" (need for an endotracheal tube) of the use of THRIVE during the procedure. Results A failure occurred in N = 15/99 patients (15.2%) mainly due to refractory hypoxia. The odd ratios (OR) for THRIVE failure were: OR = 6.6 [2.9-35] for overweight (BMI >25 kg/m2); OR = 3.8 [1.7-18.7] for ASA score >2; OR = 4.7 [2.3-24.7] for the use of CO2 laser. Elderly patients and patients with pulmonary pathology were not statistically at greater risk of THRIVE failure. No adverse event was described. Conclusion This work confirms the feasibility of laryngeal microsurgery under THRIVE, including with CO2 laser. Overweight, ASA >2 and lower fraction of inspired oxygen during CO2 laser use increased the risk for orotracheal intubation.
Collapse
Affiliation(s)
- Tiffany Rigal
- Department of Otolaryngology–Head and Neck SurgeryFoch HospitalSuresnesFrance
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
| | - Robin Baudouin
- Department of Otolaryngology–Head and Neck SurgeryFoch HospitalSuresnesFrance
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
| | - Marta Circiu
- Department of Otolaryngology–Head and Neck SurgeryFoch HospitalSuresnesFrance
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
| | - Florent Couineau
- Department of Otolaryngology–Head and Neck SurgeryFoch HospitalSuresnesFrance
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
| | - Jérôme Lechien
- Department of Otolaryngology–Head and Neck SurgeryFoch HospitalSuresnesFrance
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
- Department of OtolaryngologyElsan Polyclinic of PoitiersPoitiersFrance
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research, Institute for Health Sciences and TechnologyUniversity of Mons (UMons)MonsBelgium
- Division of Laryngology and Broncho‐EsophagologyEpiCURA HospitalBaudourBelgium
| | - Lise Crevier‐Buchman
- Department of Otolaryngology–Head and Neck SurgeryFoch HospitalSuresnesFrance
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
- Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3)ParisFrance
| | - Morgan Le Guen
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
- Department of Anesthesiology, Foch HospitalSchool of MedicineSuresnesFrance
- Simulation CenterFoch HospitalSuresnesFrance
| | - Stéphane Hans
- Department of Otolaryngology–Head and Neck SurgeryFoch HospitalSuresnesFrance
- School of Medicine, UFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)Montigny‐le‐BretonneuxFrance
- Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3)ParisFrance
| |
Collapse
|
4
|
Allegra E, Bianco MR, Modica DM, Azzolina A, Privitera E, Latella D, Occhiuzzi F, Galfano M, Saita V. Multicentric Study on Oncological Outcomes and Prognostic Factors of Open Partial Horizontal Laryngectomies. EAR, NOSE & THROAT JOURNAL 2024:1455613231225906. [PMID: 38321705 DOI: 10.1177/01455613231225906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Objective: In recent years, the number of open preservation surgeries for the treatment of laryngeal Cancer has increased. This surgery aims to maintain laryngeal function and ensure oncological radicality, thereby avoiding a total laryngectomy (TL) that could significantly impact the patient's quality of life. The purpose of this study was to assess the oncologic results of OPHL I and II and to identify prognostic factors that could impact patient survival and local failure rates. Methods: This study was conducted on 182 patients with laryngeal squamous cell carcinoma treated with OPHLs between 2005 and 2015. The survival rates of a group of patients treated with TL between 2004 and 2014 were taken into consideration to compare survival outcomes. Results: The disease-specific survival in pT2 and pT3 tumors in relation to the type of surgery showed no statistically significant difference between OPHLs and TL (P = .54 and P = .63, respectively). The 5-year T-recurrence-free survival showed that pT4 tumors, perineural/vascular positive invasion, and OPHL IIb + ARY-treated tumors were associated with a higher risk of tumor recurrence (P < .0001, P = .0005 and P = .016 respectively). Conclusions: OPHLs represent an excellent alternative to TL considering the characteristics of the tumor and the general conditions of the patient.
Collapse
Affiliation(s)
- Eugenia Allegra
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Maria Rita Bianco
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | | | - Alfio Azzolina
- Otolaryngology Unit, Cannizzaro Hospital, Catania, Italy
| | - Elio Privitera
- Otolaryngology Unit, Cannizzaro Hospital, Catania, Italy
| | - Daniele Latella
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | | | - Mario Galfano
- Otolaryngology Unit, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Vincenzo Saita
- Otolaryngology Unit, Cannizzaro Hospital, Catania, Italy
| |
Collapse
|
5
|
Yang Y, Wang YL, Wei LZ, Wang JX, Huang FT, Huang GW. Is CO 2 laser microsurgery better than radiotherapy in early glottic cancer: a meta-analysis. Lasers Med Sci 2023; 38:223. [PMID: 37758965 PMCID: PMC10533611 DOI: 10.1007/s10103-023-03890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
The choice between radiotherapy (RT) and CO2 laser surgery (CO2-LS) for early glottic cancer remains controversial. We systematically examined electronic databases in order to identify prospective trials comparing patients who had undergone CO2-LS or RT to treat early glottic cancer. Eleven studies involving 1053 patients were included. In the selected literature, the parameter setting of CO2 laser equipment can be summarized as wavelength 10.6 µm, superpulsed mode, continuous setting, power tailored on target structures (1-3 W for subtle resections and 4-15 W for cutting a larger tumor), and approximately 2080-3900 W/cm2 of laser energy. Using RevMan 5.3, we estimated pooled odds ratios (ORs) for dichotomous variables and pooled mean differences (MDs) for continuous variables, along with associated 95% confidence intervals (CIs). The heterogeneity in the treatment variables was measured using Higgins' inconsistency test and expressed as I2 values. The continuous variables were then depicted as histograms developed using PlotDigitizer 2.6.8. Compared to patients treated with CO2-LS, those treated with RT had better jitter (MD 1.27%, 95% CI 1.21 ~ 1.32, P < 0.001), and high scores on the "Grade (MD 6.54, 95% CI 5.31 ~ 7.76, P < 0.001), Breathiness (MD 9.08, 95% CI 4.02 ~ 14.13, P < 0.001), Asthenia (MD 2.13, 95% CI 0.29 ~ 3.98, P = 0.02), and Strain (MD 3.32, 95% CI 0.57 ~ 6.07, P = 0.02)" scale. Patients treated with CO2-LS had worse local control rates (OR 3.14, 95% CI 1.52 ~ 6.48, P = 0.002) while lower incidence of second primary tumor (OR 0.30, 95% CI 0.15 ~ 0.61, P < 0.001). It is hoped that retrospective analysis can provide suggestions for early glottis patients to choose personalized treatment.
Collapse
Affiliation(s)
- Yong Yang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, No.6 of Shuangyong Road, Nanning, 530021, Guangxi, China
- Department of Otolaryngology-Head and Neck Surgery, The First People's Hospital of Nanning, Nanning, 530021, Guangxi, China
| | - Yong-Li Wang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, No.6 of Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Li-Zhi Wei
- Department of Otolaryngology-Head and Neck Surgery, The First People's Hospital of Nanning, Nanning, 530021, Guangxi, China
| | - Ju-Xin Wang
- Department of Otolaryngology-Head and Neck Surgery, The First People's Hospital of Nanning, Nanning, 530021, Guangxi, China
| | - Fang-Ting Huang
- Department of Otolaryngology-Head and Neck Surgery, The First People's Hospital of Nanning, Nanning, 530021, Guangxi, China
| | - Guang-Wu Huang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, No.6 of Shuangyong Road, Nanning, 530021, Guangxi, China.
| |
Collapse
|
6
|
Arboleda LPA, Neves AB, Kohler HF, Vartanian JG, Candelária LM, Borges MF, Fernandes GA, de Carvalho GB, Kowalski LP, Brennan P, Santos‐Silva AR, Curado MP. Overview of glottic laryngeal cancer treatment recommendation changes in the NCCN guidelines from 2011 to 2022. Cancer Rep (Hoboken) 2023; 6:e1837. [PMID: 37288471 PMCID: PMC10432469 DOI: 10.1002/cnr2.1837] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/27/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The treatment of glottic cancer remains challenging, especially with regard to morbidity reduction and larynx preservation rates. The National Comprehensive Cancer Network (NCCN) has published guidelines to aid decision-making about this treatment according to the tumor site, clinical stage, and patient medical status. AIM The present review was conducted to identify changes in the NCCN guidelines for glottic cancer treatment made between 2011 and 2022 and to describe the published evidence concerning glottic cancer treatment and oncological outcomes in the same time period. METHODS AND RESULTS Clinical practice guidelines for head and neck cancer published from 2011 up to 2022 were obtained from the NCCN website (www.NCCN.org). Data on glottic cancer treatment recommendations were extracted, and descriptive analysis was performed. In addition, a review of literature registered in the PubMed database was performed to obtain data on glottic cancer management protocols and treatment outcomes from randomized controlled trials, systematic reviews, and meta-analyses published from 2011 to 2022. In total, 24 NCCN guidelines and updates and 68 relevant studies included in the PubMed database were identified. The main guideline changes made pertained to surgical and systemic therapies, the consideration of adverse features, and new options for the treatment of metastatic disease at initial presentation. Early-stage glottic cancer received the most research attention, with transoral endoscopic laser surgery and radiotherapy assessed and compared as the main treatment modalities. Reported associations between treatment types and survival rates for this stage of glottic cancer appear to be similar, but functional outcomes can be highly compromised. CONCLUSION NCCN panel members provide updated recommendations based on currently accepted treatment approaches for glottic cancer, constantly reviewing new surgical and non-surgical techniques. The guidelines support decision-making about glottic cancer treatment that should be individualized and prioritize patients' quality of life, functionality, and preferences.
Collapse
Affiliation(s)
| | | | - Hugo Fontan Kohler
- Head and Neck Surgery and Otorhinolaryngology DepartmentA.C. Camargo Cancer CenterSão PauloBrazil
| | - José Guilherme Vartanian
- Head and Neck Surgery and Otorhinolaryngology DepartmentA.C. Camargo Cancer CenterSão PauloBrazil
| | | | - Matheus Ferraz Borges
- Group of Epidemiology and Statistics on CancerA.C. Camargo Cancer CenterSão PauloSPBrazil
| | | | | | - Luiz Paulo Kowalski
- Head and Neck Surgery and Otorhinolaryngology DepartmentA.C. Camargo Cancer CenterSão PauloBrazil
- Head and Neck Surgery Department, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Paul Brennan
- International Agency for Research on CancerGenomic Epidemiology BranchLyonFrance
| | | | - Maria Paula Curado
- Group of Epidemiology and Statistics on CancerA.C. Camargo Cancer CenterSão PauloSPBrazil
| |
Collapse
|
7
|
de Ridder M, Rijken JA, Smits HJG, Smid EJ, Doornaert PAH, de Bree R. Oncological outcome of vocal cord-only radiotherapy for cT1-T2 glottic laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2023; 280:3345-3352. [PMID: 36881167 DOI: 10.1007/s00405-023-07904-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Early-stage glottic cancer can be treated with radiotherapy only. Modern radiotherapy solutions allow for individualized dose distributions, hypofractionation and sparing of organs at risk. The target volume used to be the entire voice box. This series describe the oncological outcome and toxicity of individualized vocal cord-only hypofractionated radiotherapy for early stage (cT1a-T2 N0). METHODS Retrospective cohort study with patients treated in a single center between 2014 and 2020. RESULTS A total of 93 patients were included. Local control rate was 100% for cT1a, 97% for cT1b and 77% for cT2. Risk factor for local recurrence was smoking during radiotherapy. Laryngectomy-free survival was 90% at 5 years. Grade III or higher late toxicity was 3.7%. CONCLUSION Vocal cord-only hypofractionated radiotherapy appears to be oncologically safe in early-stage glottic cancer. Modern, image-guided radiotherapy led to comparable results as historical series with very limited late toxicity.
Collapse
Affiliation(s)
- Mischa de Ridder
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, Postbox 85500, 3508 GA, Utrecht, The Netherlands.
| | - Johannes A Rijken
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hilde J G Smits
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Ernst J Smid
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Patricia A H Doornaert
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, Postbox 85500, 3508 GA, Utrecht, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
8
|
Colizza A, Ralli M, D'Elia C, Greco A, de Vincentiis M. Voice quality after transoral CO 2 laser microsurgery (TOLMS): systematic review of literature. Eur Arch Otorhinolaryngol 2022; 279:4247-4255. [PMID: 35505113 PMCID: PMC9363323 DOI: 10.1007/s00405-022-07418-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/20/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Transoral laser microsurgery (TOLMS) with carbon dioxide is a safe approach for laryngeal carcinoma. In literature there are three main methods for evaluating speech outcomes: acoustic and aerodynamics analysis, perceptual evaluation and patient-reported outcomes (PROs). The aim of this study was to systematically review the literature about the voice quality outcomes of TOLMS according to type of cordectomy. METHODS A systematic literature review was performed and all the results until December 2021 were extrapolated. We evaluated the acoustic and aerodynamics parameters (fundamental frequency, harmonics to noise ratio, jitter, shimmer and maximum phonation time), perceptual data (GRBAS scale) and patient-related outcomes (VHI scale). RESULTS 24 studies met the inclusion criteria for a total number of 1207 patients enrolled. The number for each type of cordectomy are: 287 type I (23.78%), 311 type II (25.78%), 328 type III (27.14%), 129 type 4 (10.69%) and 152 type V (12.60%). Patients are grouped according to the type of cordectomy in: limited cordectomy (type I and II) and extended cordectomy (types III-IV-V). The difference between two groups is statistically significative in terms of acoustic analysis, perceptual data and patient-related outcomes (p < 0.05). CONCLUSIONS Patients who underwent type I or II cordectomy have significantly better quality of voice in terms of VHI, perceptual voice quality evaluations and acoustic parameters compared to type III, IV and V cordectomies. The effect of TOLMS on the voice should depend from the extent of the resection and in particular from the scar of the vocal muscle.
Collapse
Affiliation(s)
- Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy.
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Chiara D'Elia
- Otorhinolaryngology Unit, Policlinico Umberto I, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
9
|
de Leo AN, Dagan R, Morris CG, Holtzman AL, Hitchcock KE, Bryant CM, Amdur RJ, Mendenhall WM. Early-stage vocal cord cancer treated with hypofractionated radiotherapy to the larynx with or without concurrent chemotherapy. Head Neck 2022; 44:2513-2521. [PMID: 35950338 DOI: 10.1002/hed.27165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/17/2022] [Accepted: 07/15/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND We report outcomes among patients with T2 and select T3 glottic squamous cell carcinoma (SCC) treated with radiotherapy. METHODS We reviewed T2 and T3 (only paraglottic space invasion) N0 M0 glottic SCC patients treated with curative-intent hypofractionated larynx radiotherapy, with or without concurrent systemic therapy. RESULTS Of 71 patients, those who received concurrent chemotherapy (23/71; 32%) had worse prognostic factors, including impaired cord mobility (70% vs. 40%, p = 0.02) and larger median gross tumor volume (3.0 vs. 1.6 cm3 , p = 0.003). Over a median follow-up of 3.8 years, 2-year local control among patients with impaired cord mobility appeared higher for those who received chemotherapy (88% vs. 61%, p = 0.12), but the difference was not statistically significant. Acute and late toxicity rates were not higher among patients who received chemotherapy. CONCLUSIONS The addition of concurrent platinum-based chemotherapy to hypofractionated larynx radiotherapy among patients with early-stage glottic SCC with impaired cord mobility appears safe and worthy of additional investigation.
Collapse
Affiliation(s)
- Alexandra N de Leo
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| | - Roi Dagan
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| | - Christopher G Morris
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| | - Adam L Holtzman
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| | - Kathryn E Hitchcock
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| | - Curtis M Bryant
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| | - Robert J Amdur
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.,Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, USA
| |
Collapse
|
10
|
de Vincentiis M, Greco A, Campo F, Candelori F, Ralli M, Di Traglia M, Colizza A, Cambria F, Zocchi J, Manciocco V, Spriano G, Pellini R. Open partial horizontal laryngectomy for T2-T3-T4a laryngeal cancer: oncological outcomes and prognostic factors of two Italian hospitals. Eur Arch Otorhinolaryngol 2022; 279:2997-3004. [PMID: 34978589 DOI: 10.1007/s00405-021-07238-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of this study was to analyse the oncologic results of open partial horizontal laryngectomy (OPHL) and to assess the prognostic factors that could affect the survival of patients affected by T2, T3 and T4a laryngeal cancer. Using this data, we aim to identify clinical criteria to select patients amenable to conservative surgery, and to facilitate a more targeted approach in the management of advanced laryngeal cancer. METHODS A retrospective study was performed in patients who underwent OPHL type II for laryngeal squamous cell carcinoma from January 2005 to December 2018. We analysed a total of 170 patients; 21(12.36%) cases were staged as pT2, 116 (68.23%) as pT3 and 33 (19.41%) as pT4a. RESULTS Five-year overall survival (OS) was 80.9%, 79.3%, 70.4% for T2, T3 and T4 respectively. Disease-specific survival (DSS) was 90.4%, 85.3% and 77.4%. Posterior tumour extension, perineural invasion and N status showed to considerably influence survival in both uni- and multivariate analyses. CONCLUSION The oncological outcomes from our study show that OPHL for advanced laryngeal cancer can guarantee a high percentage of success. Accurate patient selection is of utmost importance to differentiate advanced disease amenable to conservative surgery, and treatment options should consider selected criteria based on tumour and patient features.
Collapse
Affiliation(s)
- Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Flaminia Campo
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy.,Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Candelori
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Mario Di Traglia
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy.
| | - Francesca Cambria
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Jacopo Zocchi
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Manciocco
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Spriano
- Otorhinolaryngology Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| |
Collapse
|
11
|
Vilaseca I, Aviles-Jurado FX, Valduvieco I, Berenguer J, Grau JJ, Baste N, Muxí Á, Castillo P, Lehrer E, Jordana M, Ramírez-Ruiz RD, Costa JM, Oleaga L, Bernal-Sprekelsen M. Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments. Head Neck 2021; 43:3832-3842. [PMID: 34569120 DOI: 10.1002/hed.26878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/09/2021] [Accepted: 09/08/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. METHODS Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated. RESULTS The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085-0.979]) and anterior (HR = 0.278 [0.128-0.605]) and posterior (HR = 0.269 [0.115-0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1.537-8.495]) and posterior (HR = 5.195 [2.167-12.455]) PGS involvement were independent factors of total laryngectomy. Five-year OS, DSS, and LFS rates were 63.9%, 77.5%, and 77.5%, respectively. Patients with posterior PGS presented a reduced 5-year LFS. CONCLUSIONS Tumor classification according to laryngeal compartmentalization depicts strong correlation with LC and LFS.
Collapse
Affiliation(s)
- Isabel Vilaseca
- Otorhinolaryngology Head Neck Surgery Department, Hospital Clínic, Barcelona, Spain.,School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Head Neck Clínic, Agència de Gestió d'Ajuts Universitaris i de Recerca, Barcelona, Spain
| | - Francesc Xavier Aviles-Jurado
- Otorhinolaryngology Head Neck Surgery Department, Hospital Clínic, Barcelona, Spain.,School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Head Neck Clínic, Agència de Gestió d'Ajuts Universitaris i de Recerca, Barcelona, Spain
| | - Izaskun Valduvieco
- School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Head Neck Clínic, Agència de Gestió d'Ajuts Universitaris i de Recerca, Barcelona, Spain.,Radiation Oncology Department, Hospital Clínic, Barcelona, Spain
| | - Joan Berenguer
- School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Radiology Department, Hospital Clínic, Barcelona, Spain
| | - Juan José Grau
- School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Head Neck Clínic, Agència de Gestió d'Ajuts Universitaris i de Recerca, Barcelona, Spain.,Medical Oncology Department, Hospital Clínic, Barcelona, Spain
| | - Neus Baste
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Medical Oncology Department, Hospital Clínic, Barcelona, Spain
| | - África Muxí
- School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain
| | - Paola Castillo
- School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Pathology Department, Hospital Clínic, Barcelona, Spain
| | - Eduardo Lehrer
- Otorhinolaryngology Head Neck Surgery Department, Hospital Clínic, Barcelona, Spain.,School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain
| | - Marta Jordana
- Otorhinolaryngology Head Neck Surgery Department, Hospital Clínic, Barcelona, Spain.,Rehabilitation Department, Hospital Clínic, Barcelona, Spain
| | | | - José Miguel Costa
- Otorhinolaryngology Head Neck Surgery Department, Hospital Clínic, Barcelona, Spain
| | - Laura Oleaga
- School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain.,Radiology Department, Hospital Clínic, Barcelona, Spain
| | - Manuel Bernal-Sprekelsen
- Otorhinolaryngology Head Neck Surgery Department, Hospital Clínic, Barcelona, Spain.,School of Medicine, Department of Surgery and Medical-Surgical Specialties, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| |
Collapse
|
12
|
Campo F, Zocchi J, Moretto S, Mazzola F, Petruzzi G, Donà MG, Benevolo M, Iocca O, De Virgilio A, Pichi B, Manciocco V, Pellini R. Cell-Free Human Papillomavirus-DNA for Monitoring Treatment Response of Head and Neck Squamous Cell Carcinoma: Systematic Review and Meta-Analysis. Laryngoscope 2021; 132:560-568. [PMID: 34236084 DOI: 10.1002/lary.29739] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/22/2021] [Accepted: 06/26/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aim of this study was to assess the value of cell-free human papillomavirus-DNA (cfHPV-DNA) as a diagnostic test for the post-treatment surveillance of patients with HPV-positive head and neck squamous cell carcinoma (HNSCC) through a systematic review and meta-analysis. STUDY DESIGN Systematic review and meta-analysis. METHODS A literature search was conducted in three databases (MEDLINE, Embase, and Scopus) in January 2021. The population included patients with HPV-positive HNSCC. The intervention was the use of the repeated liquid biopsy with circulating HPV-DNA detection during follow-up. The outcome was to establish the value of cfHPV-DNA as a diagnostic test for the post-treatment surveillance of patients with HPV-positive HNSCC. RESULTS Ten studies included in the meta-analysis provided a total of 457 patients with HPV-positive HNSCC. The meta-analytic study estimated the diagnostic performance of cfHPV-DNA as follows: pooled sensitivity and specificity of 0.65 (95% confidence interval [CI]: 0.40-0.84) and 0.99 (99% CI: 0.96-0.99), respectively; positive and negative likelihood ratios of 62.5 (99% CI: 22.9-170.2) and 0.05 (99% CI: 0.013-0.24), respectively; and pooled diagnostic odds ratio of 371.66 (99% CI: 60.4-2286.7). CONCLUSION Currently, the follow-up protocol for HNSCC patients includes routine clinical evaluation and radiological imaging. Biomarkers to monitor this disease are not established. Considering its high specificity, cfHPV-DNA represents a potential confirmatory test in the case of positive positron emission tomography and computed tomography. In the near future, cfHPV-DNA could be used as a biomarker for monitoring the treatment response during the clinical trials of de-escalation therapy or immunotherapy. Larger sample sizes and the homologation of study protocols and methodology are needed to better establish its utility in the clinical practice. Laryngoscope, 2021.
Collapse
Affiliation(s)
- Flaminia Campo
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy.,Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Jacopo Zocchi
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Silvia Moretto
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Francesco Mazzola
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Gerardo Petruzzi
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Maria G Donà
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Maria Benevolo
- Department of Pathology, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Oreste Iocca
- Division of Maxillofacial Surgery, Surgical Science Department, University of Torino, Torino, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Barbara Pichi
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Valentina Manciocco
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| |
Collapse
|
13
|
Campo F, Ralli M, Di Stadio A, Greco A, Pellini R, de Vincentiis M. Role of Narrow Band Imaging Endoscopy in Preoperative Evaluation of Laryngeal Leukoplakia: A Review of the Literature. EAR, NOSE & THROAT JOURNAL 2020; 101:NP403-NP408. [PMID: 33213196 DOI: 10.1177/0145561320973770] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Leukoplakia is a precancerous lesion considered to be within the spectrum of histopathological results from parakeratosis, through stages of dysplasia to invasive cancer. Narrow band imaging (NBI) endoscopy has been introduced to improve early diagnosis of benign and malignant laryngeal lesions. The aim of this literature review was to evaluate the accuracy of preoperative evaluation of vocal fold leukoplakia with NBI endoscopy in comparison with histology. METHODS A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using 3 different databases: PubMed, Embase, and Scopus. The included articles in the systematic review were identified combining each of the following terms: "narrow band imaging" OR "NBI," [AND] with each of these terms: "laryngeal leukoplakia," OR "vocal fold leukoplakia," OR "vocal cord leukoplakia." RESULTS The articles that fully met the inclusion criteria were 5 case series, conducted between January 2010 and February 2018, and published between 2017 and 2019. The selected articles included 312 patients (86% males and 14% females), affected by 382 vocal cord leukoplakia, evaluated with NBI endoscopy and that underwent surgical microlaryngoscopy with biopsy. Based on the studies included in the review, accuracy of NBI in predicting malignancy within leukoplakia ranged from 81% to 97.8%, demonstrating to be an accurate method to predict the risk of malignant transformation of vocal fold leukoplakia. CONCLUSION Narrow band imaging can help otolaryngologists in the decision-making process on the necessity to perform a biopsy and transoral surgery or long-term follow-up. Larger studies are necessary to confirm the high association of NBI evaluation of the epithelium surrounding the leukoplakia with the histological diagnosis.
Collapse
Affiliation(s)
- Flaminia Campo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Raul Pellini
- Department of Otolaryngology and Head and Neck Surgery, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
14
|
Ralli M, Campo F, Angeletti D, Allegra E, Minni A, Polimeni A, Greco A, de Vincentiis M. Obstructive Sleep Apnoea in Patients Treated for Head and Neck Cancer: A Systematic Review of the Literature. ACTA ACUST UNITED AC 2020; 56:medicina56080399. [PMID: 32784361 PMCID: PMC7466207 DOI: 10.3390/medicina56080399] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/30/2020] [Accepted: 08/06/2020] [Indexed: 11/24/2022]
Abstract
Background and objectives: Obstructive sleep apnoea (OSA) is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep. The literature is still controversial on the incidence and aetiology of OSA secondary to head and neck cancer treatment. The aim of this systematic review is to evaluate and discuss the prevalence of OSA in patients treated with surgery and/or chemo/radiotherapy for head and neck cancer. Materials and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was performed on May 2020 using the MEDLINE database, Scopus, and Google Scholar. The searches were conducted using combinations of the following terms: head and neck cancer, OSA, radiotherapy, chemotherapy, partial laryngectomy, laryngeal cancer, neoplasm, tumour, carcinoma, and oropharyngeal cancer. Results: Our results suggest that head and neck cancer patients have a higher incidence of OSA (59.78%) compared to the general population; differences may occur based on the type of treatment. Conclusions: Clinicians should recognise the higher prevalence of OSA in patients treated for head and neck cancer and should consider a comprehensive sleep history as part of the evaluation and management of these patients. Further research is needed to evaluate the exact prevalence, aetiology, and correct management of OSA after treatment for head and neck cancer.
Collapse
Affiliation(s)
- Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
- Correspondence: ; Tel.: +39-0649976808
| | - Flaminia Campo
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Diletta Angeletti
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Eugenia Allegra
- Otolaryngology Department of Health Science, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (A.P.); (M.d.V.)
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (A.P.); (M.d.V.)
| |
Collapse
|