American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer
Autor: | Susan G. Fisher, Nancy Leupold, Louis B. Harrison, Kie-Kian Ang, David J. Adelstein, Arlene A. Forastiere, Marcy A. List, Gregory S. Weinstein, Gregory T. Wolf, Bernard O'Malley, Gary Clayman, Michael A. Schwartz, William M. Mendenhall, David G. Pfister, Marshall R. Posner, Snehal G. Patel, Scott A. Laurie, Jean-Louis Lefebvre |
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Rok vydání: | 2006 |
Předmět: |
Cancer Research
medicine.medical_specialty medicine.medical_treatment Laryngectomy law.invention Tracheostomy Randomized controlled trial law Adjuvant therapy medicine Humans Prospective Studies Patient participation Intensive care medicine Laryngeal Neoplasms Societies Medical Neoplasm Staging Randomized Controlled Trials as Topic Evidence-Based Medicine business.industry Standard treatment Patient Selection Evidence-based medicine Guideline Survival Analysis Surgery Clinical trial Treatment Outcome Oncology Clinical Trials Phase III as Topic Lymphatic Metastasis Quality of Life Larynx Patient Participation business Deglutition Disorders |
Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 24(22) |
ISSN: | 1527-7755 |
Popis: | Purpose To develop a clinical practice guideline for treatment of laryngeal cancer with the intent of preserving the larynx (either the organ itself or its function). This guideline is intended for use by oncologists in the care of patients outside of clinical trials. Methods A multidisciplinary Expert Panel determined the clinical management questions to be addressed and reviewed the literature available through November 2005, with emphasis given to randomized controlled trials of site-specific disease. Survival, rate of larynx preservation, and toxicities were the principal outcomes assessed. The guideline underwent internal review and approval by the Panel, as well as external review by additional experts, members of the American Society of Clinical Oncology (ASCO) Health Services Committee, and the ASCO Board of Directors. Results Evidence supports the use of larynx-preservation approaches for appropriately selected patients without a compromise in survival; however, no larynx-preservation approach offers a survival advantage compared with total laryngectomy and adjuvant therapy with rehabilitation as indicated. Recommendations All patients with T1 or T2 laryngeal cancer, with rare exception, should be treated initially with intent to preserve the larynx. For most patients with T3 or T4 disease without tumor invasion through cartilage into soft tissues, a larynx-preservation approach is an appropriate, standard treatment option, and concurrent chemoradiotherapy therapy is the most widely applicable approach. To ensure an optimum outcome, special expertise and a multidisciplinary team are necessary, and the team should fully discuss with the patient the advantages and disadvantages of larynx-preservation options compared with treatments that include total laryngectomy. |
Databáze: | OpenAIRE |
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