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Akanabe R, Shiga K, Katagiri K, Saito D, Oikawa SI, Ikeda A, Tsuchida K, Miyaguchi J, Kusaka T, Kishima Y, Ariga H. Effects of Chemotherapy and Radiation Therapy on Early Laryngeal Cancers. CANCER DIAGNOSIS & PROGNOSIS 2024; 4:459-463. [PMID: 38962536 PMCID: PMC11215446 DOI: 10.21873/cdp.10348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/08/2024] [Indexed: 07/05/2024]
Abstract
Background/Aim Treatments for early laryngeal squamous cell carcinoma (SCC) include radiotherapy (RT), chemoradiotherapy (CRT), and larynx-preserving surgery. In this study, early laryngeal SCC was treated with RT in patients with stage I (T1N0) tumors and with CRT and docetaxel (DOC) in patients with stage II (T2N0) tumors and the treatment results and effectiveness of the chemotherapy were compared. Patients and Methods A total of 78 patients with early-stage laryngeal SCC were enrolled in this study. The T1N0 patients received radiation for the primary lesions as outpatients at a total dose of 63-70 Gy. By contrast, the T2N0 patients were hospitalized and treated with CRT, receiving a total radiation dose of 66-70 Gy. Docetaxel (DOC, 10 mg/m2) was administered intravenously once a week for 6-8 consecutive weeks concurrently with radiotherapy. The adverse events and survival rates with local control rates were examined. Results The number of non-glottic T2N0 patients was significantly higher than that of T1N0 patients. Although all patients completed their treatment schedule, significantly more grade 3 adverse events were observed in the T2N0 patients, in particular mucositis and dermatitis, than in T1N0 patients. The 5-year overall survival rate, disease specific survival rate, local control rate, and laryngeal preserve rate of the T1N0 and T2N0 patients were 86.1, 93.3, 88.6, and 94.3% and 85.9, 88.0, 93.1, and 93.1%, respectively. Conclusion CRT with docetaxel showed the best therapeutic outcomes for the treatment of laryngeal SCC in patients with T2N0 tumours, with a higher local control rate, effective laryngeal preservation, and relatively few adverse events.
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Affiliation(s)
- Ryouhei Akanabe
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Kiyoto Shiga
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Katsunori Katagiri
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Daisuke Saito
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Shin-Ichi Oikawa
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Aya Ikeda
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Kodai Tsuchida
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Jun Miyaguchi
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Takahiro Kusaka
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Yuki Kishima
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Hisanori Ariga
- Department of Radiology, Iwate Medical University School of Medicine, Yahaba, Japan
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Mizukami T, Yamagishi K, Tobikawa M, Nakazato A, Abe H, Morita Y, Saitoh JI. Accelerated Fractionated Radiation Therapy for Localized Glottic Carcinoma. Curr Oncol 2024; 31:2636-2643. [PMID: 38785479 PMCID: PMC11119052 DOI: 10.3390/curroncol31050198] [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: 04/10/2024] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The aim of this study is to examine the outcomes of an accelerated fractionated irradiation for N0 glottic carcinoma. METHODS In this retrospective analysis, 29 patients with N0 glottic carcinoma treated by radiation therapy were enrolled. Thirteen patients had T1a disease, six had T1b disease, and ten had T2 disease. A fractional dose of 2.1 Gy was administered to seven patients. The total doses were 65.1 and 67.2 Gy in four and three patients, respectively. A fractional dose of 2.25 Gy was administered to 22 patients. The total doses were 63 and 67.5 Gy in 21 patients and 1 patient with T2 disease, respectively. Additionally, 13 patients underwent the use of TS-1 (80-100 mg per day). RESULTS The median follow-up period was 33 months, and the 3-year local control rate was 95.6%. No patient had a lymph node or distant recurrence. As acute adverse events, grades 2 and 3 dermatitis were observed in 18 patients and 1 patient, and grades 2 and 3 mucositis were observed in 15 patients and 1 patient. As a late adverse event, one patient required tracheotomy because of laryngeal edema occurring. CONCLUSIONS Accelerated fractionated irradiation may be an option in the radiation therapy of N0 glottic carcinoma because of its ability to shorten the treatment time.
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Affiliation(s)
- Tatsuji Mizukami
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 930-0194, Japan (J.-i.S.)
| | - Kentaro Yamagishi
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 930-0194, Japan (J.-i.S.)
| | - Masaki Tobikawa
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 930-0194, Japan (J.-i.S.)
| | - Akira Nakazato
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Toyama, Toyama 930-0194, Japan
| | - Hideharu Abe
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Toyama, Toyama 930-0194, Japan
| | - Yuka Morita
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Toyama, Toyama 930-0194, Japan
| | - Jun-ichi Saitoh
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 930-0194, Japan (J.-i.S.)
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Lee KC, Chuang SK. The nonsurgical management of early stage (T1/2 N0 M0) laryngeal cancer: A population analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:18-24. [PMID: 32487468 DOI: 10.1016/j.oooo.2020.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/17/2019] [Accepted: 01/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the patterns of care and survival in the nonsurgical management of early-stage (T1/2 N0 M0) laryngeal cancer. STUDY DESIGN This was a retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) database during the period 2004 to 2015. Patients diagnosed with T1/2 N0 M0 laryngeal SCC definitively treated without surgery were included. Study predictors were age, gender, race, marital status, histologic grade, stage, and management strategy defined as radiotherapy (RT), chemotherapy, chemoradiotherapy (CRT), or no treatment. Study outcomes were overall survival (OS) and disease-specific survival (DSS). RESULTS In total, 3221 patients comprised the final sample. Over half of the lesions were stage I (63.8%); 74.0%, 24.8%, and 1.2% were located in the glottis, supraglottis, and subglottis, respectively. RT (77.6%) was the preferred nonsurgical treatment modality, followed by CRT (12.7%). A greater proportion of patients with stage II disease (25.1%) received CRT compared with those with stage I (5.6%). Similarly, patients receiving CRT were significantly younger and more likely to present with higher-grade lesions located in the supraglottis and subglottis. In the multivariate model, the risks of both disease-specific and overall death were increased by age, male gender, supraglottic and subglottic location, stage II disease, CRT, and no treatment. CONCLUSIONS Definitive RT was the preferred treatment modality regardless of tumor characteristics. CRT was more often selectively reserved for younger patients with higher grade, stage II tumors located in the supraglottis and subglottis. This approach may be driven by the poorer rates of survival associated with these particular characteristics. CRT did not appear to improve survival in comparison with RT after controlling for subsite and disease severity; however, future clinical studies are required to validate this finding.
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Affiliation(s)
- Kevin C Lee
- Resident, Division of Oral and Maxillofacial Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
| | - Sung-Kiang Chuang
- Clinical Professor, Department of Oral and Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA, USA; Private Practice, Brockton Oral and Maxillofacial Surgery Inc., Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, MA, USA
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Survival and Prognostic Factors for Outcome after Radiotherapy for T2 Glottic Carcinoma. Cancers (Basel) 2019; 11:cancers11091319. [PMID: 31500162 PMCID: PMC6770714 DOI: 10.3390/cancers11091319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Local recurrence after radiotherapy for T2 glottic carcinoma remains an issue and identifying patients at risk for relapse is, therefore, important. This study aimed to assess the oncological outcomes and prognostic factors in a consecutive series of patients treated with radiotherapy for T2N0 glottic carcinoma. Methods: Patients with T2N0 glottic carcinoma treated with radiotherapy were included in this retrospective study. Five- and ten-year local control (LC), overall survival (OS), disease-specific survival (DSS), and laryngeal preservation (LP) rates were calculated with the Kaplan–Meier method. The impact of prognostic variables was evaluated with the log-rank test. Results: Ninety-four patients were included for analysis. LC, OS, DSS, and LP rates were 70.5, 63.7, 86.0, and 74.7%, respectively at five years and 65.8, 41.0, 75.6, and 72.4% at 10 years. In total, 46 scans were included in the analyses. Vertical involvement of the anterior commissure on imaging showed a significant impact on LC. Conclusions: In accordance with previously described surgical risk factors, we identified vertical involvement of the anterior commissure on imaging as a prognostic factor for radiation failure.
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Che J, Wang Y, Zhang X, Chen J. Comparative efficacy of six therapies for Hypopharyngeal and laryngeal neoplasms: a network meta-analysis. BMC Cancer 2019; 19:282. [PMID: 30922243 PMCID: PMC6439970 DOI: 10.1186/s12885-019-5412-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 02/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Hypopharyngeal and laryngeal neoplasms are both fatal and hard to catch in early stages. Yet which treatment is the most efficacious one still remain unanswered. This network meta-analysis (NMA) was conducted to investigate effectiveness of six therapies being utilized in clinical practice nowadays. Methods PubMed and Embase were retrieved to synthesize data. Direct and indirect evidence was combined to compare efficacy of treatments. A relative ranking of the six regimens was calculated by the surface under the curve ranking area (SUCRA). Results A total of 28 trials with 9109 patients were included in our NMA. Five endpoints investigated included 3/5-year overall survival (3/5-OS), 3/5-year disease free survival (3/5-DFS) and 5-year overall survival rate (5-OSR). In terms of all efficacy outcomes, radiotherapy combined with surgery (RT + S) proved to be better than other therapies while radiotherapy (RT) alone also performed well. Induction chemoradiotherapy (ICRT) was the best regarding 3-DFS (SUCRA = 0.846) while current chemoradiotherapy (CCRT) ranked first in 5-DFS (SUCRA = 0.933) according to SUCRA results. No significant differences were demonstrated in 5-DFS and 5-OSR as shown in the results of NMA. Conclusions RT combined with surgery turned out to be optimal therapy of all the outcomes while the efficacy of RT was relatively poorer in the treatment of patients with larynx stage III-IV and hypopharynx stage II-IV. Also, the good performance of CCRT and ICRT in terms of DFS made them as secondary recommended therapies. There is no significant difference between surgery and transoral laser microsurgery (TLM) alone. Electronic supplementary material The online version of this article (10.1186/s12885-019-5412-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juan Che
- Department of Otorhinolaryngology, Binzhou Medical University Hospital, No. 661 Second Huanghe Road, Binzhou, 256603, Shandong, China
| | - Yanlin Wang
- Department of Otorhinolaryngology, Binzhou Medical University Hospital, No. 661 Second Huanghe Road, Binzhou, 256603, Shandong, China
| | - Xiaolin Zhang
- Department of Otorhinolaryngology, Binzhou Medical University Hospital, No. 661 Second Huanghe Road, Binzhou, 256603, Shandong, China
| | - Jun Chen
- Department of Otorhinolaryngology, Binzhou Medical University Hospital, No. 661 Second Huanghe Road, Binzhou, 256603, Shandong, China.
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