Radiotherapy Alone or With Chemotherapy in the Management of Carcinoma of the Supraglottic Larynx: A 25-Year Community Hospital Experience
| Autor: | Christopher G. Morris, Syed N. Rizvi, William J. McAfee, Charles M. Mendenhall, William M. Mendenhall, Amy R. Rao, Andrew Johns, Daniel A. Jones, Jessica Kirwan |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Glottis medicine.medical_treatment Hospitals Community Supraglottic larynx 03 medical and health sciences 0302 clinical medicine Laryngeal preservation Internal medicine Carcinoma Medicine Humans Stage (cooking) 030223 otorhinolaryngology Laryngeal Neoplasms Aged Retrospective Studies Aged 80 and over Chemotherapy Radiotherapy business.industry Disease Management Chemoradiotherapy Radiotherapy alone Middle Aged medicine.disease Prognosis Community hospital Surgery Survival Rate Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female business Hyperfractionation Follow-Up Studies |
| Zdroj: | American journal of clinical oncology. 41(9) |
| ISSN: | 1537-453X |
| Popis: | OBJECTIVES The purpose of this study was to retrospectively review outcomes for patients treated with definitive radiotherapy for carcinoma of the supraglottic larynx at a community hospital and to compare our results with the literature. MATERIALS AND METHODS Treatment records of 46 patients with localized carcinoma of the supraglottic larynx treated from January 1987 through January 2012 were reviewed. Overall, 18 (39%) presented with stage I or II disease, whereas 28 (61%) presented with stage III to IV. In total, 30 patients (65%) were treated using hyperfractionation, whereas 16 (35%) received once-daily fractionation. Twelve patients (26%) received concurrent chemotherapy with weekly cisplatin. The Kaplan-Meier method was used to assess outcomes. RESULTS The median follow-up for the living patients was 6.7 years (range, 1.7 to 23.1 y). At 5 years, the local-regional control (LRC), ultimate LRC, laryngeal preservation, and overall survival (OS) rates were 70%, 82%, 65%, and 53%, respectively. At 5 years, disease-free survival and cause-specific survival rates were 75% and 76%, respectively. The 5-year OS rates by American Joint Committee on Cancer stage were as follows: I to II, 61%; III, 51%; and IV, 44%. For those receiving concurrent chemotherapy, there was no improvement in 5-year LRC (83% vs. 66%; P=0.4081) or OS (55% vs. 50%; P=0.7697). For those receiving hyperfractionation, there was no improvement in 5-year LRC (75% vs. 63%; P=0.3369) or OS (55% vs. 50%; P=0.4161). CONCLUSIONS Our outcomes are similar to those reported in the literature. Neither hyperfractionation nor chemotherapy appeared to confer a benefit for disease control or OS possibly owing to small sample size and the inherent bias of a retrospective review. |
| Databáze: | OpenAIRE |
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