Use of concurrent chemoradiation in advanced staged (T4) laryngeal cancer
| Autor: | Rod Rezaee, Cameron C. Wick, Min Yao, Tammy Wang, M. K. Gibson, Pierre Lavertu, Chad A. Zender, Andrea M. Garcia-Jarchow |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Salvage therapy Laryngectomy Kaplan-Meier Estimate Risk Assessment Disease-Free Survival Metastasis Cohort Studies Treatment Refusal 03 medical and health sciences 0302 clinical medicine Tracheotomy Humans Medicine Neoplasm Invasiveness 030212 general & internal medicine Laryngeal Neoplasms Aged Neoplasm Staging Retrospective Studies Salvage Therapy business.industry Cancer Patient Preference Retrospective cohort study Chemoradiotherapy Middle Aged Laryngeal Neoplasm Prognosis medicine.disease Survival Analysis Surgery Treatment Outcome Otorhinolaryngology 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female business Organ Sparing Treatments |
| Zdroj: | American Journal of Otolaryngology. 38:72-76 |
| ISSN: | 0196-0709 |
| DOI: | 10.1016/j.amjoto.2016.10.001 |
| Popis: | Hypothesis Patients with advanced laryngeal cancer sometimes desire organ preservation protocols even if it portends a worse outcome. Background To assess outcomes of patients with T4 laryngeal cancer treated with chemoradiation therapy. Methods Case series with chart review at a tertiary university hospital. Twenty-four patients with T4 laryngeal cancer all declined total laryngectomy with adjuvant radiation as the primary treatment modality and alternatively received concurrent chemoradiation therapy. The primary outcome was overall survival. Secondary outcomes were rates of tracheotomy dependence, gastric tube dependence, and need for salvage laryngectomy. Results All patients had T4 laryngeal disease, 71% had cartilage invasion and 59% had regional metastasis to the neck. Kaplan–Meier analysis determined 2-year and 5-year overall survival to be 64% and 59% respectively. The locoregional recurrence rate was 25%. The distant metastasis rate was 21%. The rate of salvage laryngectomy was 17%, which occurred at a mean of 56.5 months after the original diagnosis. The rate of tracheotomy dependence was 33% while gastric tube dependence was 25%. Conclusion Advanced T4 laryngeal cancer, particularly with cartilage invasion, remains a surgical disease best treated with total laryngectomy and adjuvant radiation. This data may help guide patients and practitioners considering concurrent chemoradiation therapy for definitive treatment of advanced laryngeal cancer. |
| Databáze: | OpenAIRE |
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