Treatment Selection for T3/T4a Laryngeal Cancer
| Autor: | David W. Timme, Sashikanth Jonnalagadda, K. Thomas Robbins, Krishna Rao, Raunak D. Patel |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Treatment outcome Locally advanced Laryngectomy Larynx preservation medicine Humans Laryngeal Neoplasms Selection (genetic algorithm) Aged Neoplasm Staging Retrospective Studies Squamous Cell Carcinoma of Head and Neck business.industry Patient Selection General surgery Cancer Chemoradiotherapy General Medicine Middle Aged medicine.disease Surgery Survival Rate Treatment Outcome Otorhinolaryngology Head and Neck Neoplasms Carcinoma Squamous Cell Neck Dissection Female Illinois business |
| Zdroj: | Annals of Otology, Rhinology & Laryngology. 124:845-851 |
| ISSN: | 1943-572X 0003-4894 |
| DOI: | 10.1177/0003489415588130 |
| Popis: | Objective: We report the treatment outcomes, including organ preservation, for patients with locally advanced (T3/T4a) laryngeal cancer receiving both surgical and nonsurgical approaches. We hypothesize that selection of treatment protocols aimed to optimize organ preservation does not compromise survival provided careful selection is done through the process of multidisciplinary treatment planning. Methods: Patients with T3-4a laryngeal squamous cell cancer were evaluated and recommended for primary treatment with total or partial laryngectomy (37 patients) or chemoradiotherapy (34 patients). Treatment outcomes were compared between the 2 cohorts. In addition, the laryngeal preservation rate and laryngoesophageal dysfunction-free survival (LEDFS) were determined for the chemoradiation group. Results: The 5-year overall survival rate for patients with T3 lesions was 41% and 40% for the surgical and nonsurgical groups, respectively, and for T4 lesions it was 54% and 53%, respectively. For the chemoradiation group, the rate of overall laryngeal preservation was 79%. LEDFS at 2 years was 40% for T3 lesions and 33% for T4 lesions. Conclusion: Through careful selection, some patients with locally advanced laryngeal cancer can be offered chemoradiation (organ preservation) without compromising survival. However, the patients selected to receive chemoradiation have a high rate of laryngeal and esophageal dysfunction. |
| Databáze: | OpenAIRE |
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