Laryngeal Preservation Rates in Patients Treated with Definitive or Concurrent Chemo radiation: Study in A high Volume Cancer Center
DOI:
https://doi.org/10.70749/ijbr.v3i7.2366Keywords:
Laryngeal carcinoma, tumors, chemo radiation, radiotherapy, cancer center, laryngectomyAbstract
Introduction: The standard of care for patients with early-stage laryngeal cancer is radiotherapy and for locally progressed disease is concurrent chemo radiotherapy with cisplatin in all patients suitable for organ preservation. In patients not suitable for organ preservation surgery (Total laryngectomy) followed by radiotherapy is used. This organ saving treatment change from total laryngectomy to radiotherapy or concurrent chemoradiation has great impact on patients’ quality of life. Methods: This prospective study comprised a total of 100 patients. The typical follow-up time was one year. Patients with early-stage and locally progressed laryngeal carcinoma were randomly allocated to receive either radiotherapy alone or concurrent chemoradiation with cisplatin. The main goal was to keep the larynx intact. Results: Out of 100, Patients made up roughly 97% men and 3% women. Early stage groups made up 40% of the population, while locally advanced groups made up 59%. At one year, there had been no local relapse and in 89.6% of the patients larynx was preserved. It was shown that females had superior local control than males. Conclusions: These findings are significant, but it's important to keep in mind that irradiation is an effective method of treating these tumors, may have improved activity with modified fractionation or addition of simultaneous chemotherapy. Radiotherapy is a viable option to avoid total laryngectomy. On the other hand, new therapy options (biologic tools, imaging locations) and criteria for therapeutic success (quality of life, quality of maintained function, and cost-effectiveness) are emerging.
Downloads
References
1. Cattaruzza, M., Maisonneuve, P., & Boyle, P. (1996). Epidemiology of laryngeal cancer. European Journal of Cancer Part B: Oral Oncology, 32(5), 293-305.
https://doi.org/10.1016/0964-1955(96)00002-4
2. Hackenberg, S., Kraus, F., & Scherzad, A. (2021). Seltene Erkrankungen des larynx, Der trachea und Der Schilddrüse. Laryngo-Rhino-Otologie, 100(S 01), S1-S36.
https://doi.org/10.1055/a-1337-5703
3. Zhang, J., Xing, S., Liang, D., Hu, W., Ke, C., He, J., Yuan, R., Huang, Y., Li, Y., Liu, D., Zhang, X., Li, L., Lin, J., Li, W., Teng, X., Liu, Y., Wen, W., Kang, Q., Wang, D., … Xu, J. (2021). Differential antibody response to inactivated COVID-19 vaccines in healthy subjects. Frontiers in Cellular and Infection Microbiology, 11.
https://doi.org/10.3389/fcimb.2021.791660
4. Testa, D., Guerra, G., Conzo, G., Nunziata, M., D'Errico, G., Siano, M., Ilardi, G., Vitale, M., Riccitiello, F., & Motta, G. (2013). Glottic-Subglottic adenoid cystic carcinoma. A case report and review of the literature. BMC Surgery, 13(Suppl 2), S48.
https://doi.org/10.1186/1471-2482-13-s2-s48
5. Ciolofan, M. S., Vlăescu, A. N., Mogoantă, C. A., Ioniță, E., Ioniță, I., Căpitănescu, A. N., ... & Anghelina, F. (2017). Clinical, histological and immunohistochemical evaluation of larynx cancer. Current health sciences journal, 43(4), 367.
https://doi.org/10.12865/CHSJ.43.04.14
6. Schwartz, S. R., Cohen, S. M., Dailey, S. H., Rosenfeld, R. M., Deutsch, E. S., Gillespie, M. B., Granieri, E., Hapner, E. R., Kimball, C. E., Krouse, H. J., McMurray, J. S., Medina, S., O'Brien, K., Ouellette, D. R., Messinger‐Rapport, B. J., Stachler, R. J., Strode, S., Thompson, D. M., Stemple, J. C., … Patel, M. M. (2009). Clinical practice guideline: Hoarseness (Dysphonia). Otolaryngology–Head and Neck Surgery, 141(S1), 1-31.
https://doi.org/10.1016/j.otohns.2009.06.744
7. Steuer, C. E., El‐Deiry, M., Parks, J. R., Higgins, K. A., & Saba, N. F. (2016). An update on larynx cancer. CA: A Cancer Journal for Clinicians, 67(1), 31-50.
https://doi.org/10.3322/caac.21386
8. Forastiere, A. A., Ismaila, N., Lewin, J. S., Nathan, C. A., Adelstein, D. J., Eisbruch, A., Fass, G., Fisher, S. G., Laurie, S. A., Le, Q., O’Malley, B., Mendenhall, W. M., Patel, S., Pfister, D. G., Provenzano, A. F., Weber, R., Weinstein, G. S., & Wolf, G. T. (2018). Use of larynx-preservation strategies in the treatment of laryngeal cancer: American Society of Clinical Oncology clinical practice guideline update. Journal of Clinical Oncology, 36(11), 1143-1169.
https://doi.org/10.1200/jco.2017.75.7385
9. Urba, S., Wolf, G., Eisbruch, A., Worden, F., Lee, J., Bradford, C., Teknos, T., Chepeha, D., Prince, M., Hogikyan, N., & Taylor, J. (2006). Single-cycle induction chemotherapy selects patients with advanced laryngeal cancer for combined Chemoradiation: A new treatment paradigm. Journal of Clinical Oncology, 24(4), 593-598.
https://doi.org/10.1200/jco.2005.01.2047
10. Corvò, R. (2007). Evidence-based radiation oncology in head and neck squamous cell carcinoma. Radiotherapy and Oncology, 85(1), 156-170.
https://doi.org/10.1016/j.radonc.2007.04.002
11. Hinerman, R. W., Morris, C. G., Amdur, R. J., Lansford, C. D., Werning, J. W., Villaret, D. B., & Mendenhall, W. M. (2006). Surgery and postoperative radiotherapy for squamous cell carcinoma of the larynx and pharynx. American Journal of Clinical Oncology, 29(6), 613-621.
https://doi.org/10.1097/01.coc.0000242319.09994.78
12. Johnson, D. E., Burtness, B., Leemans, C. R., Lui, V. W., Bauman, J. E., & Grandis, J. R. (2020). Head and neck squamous cell carcinoma. Nature Reviews Disease Primers, 6(1).
https://doi.org/10.1038/s41572-020-00224-3
13. Forastiere, A. A., Zhang, Q., Weber, R. S., Maor, M. H., Goepfert, H., Pajak, T. F., Morrison, W., Glisson, B., Trotti, A., Ridge, J. A., Thorstad, W., Wagner, H., Ensley, J. F., & Cooper, J. S. (2013). Long-term results of RTOG 91-11: A comparison of three Nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. Journal of Clinical Oncology, 31(7), 845-852.
https://doi.org/10.1200/jco.2012.43.6097
14. Adelstein, D. J., Li, Y., Adams, G. L., Wagner, H., Kish, J. A., Ensley, J. F., Schuller, D. E., & Forastiere, A. A. (2003). An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent Chemoradiotherapy in patients with Unresectable squamous cell head and neck cancer. Journal of Clinical Oncology, 21(1), 92-98.
https://doi.org/10.1200/jco.2003.01.008
15. Pignon, J., Maître, A. L., Maillard, E., & Bourhis, J. (2009). Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patients. Radiotherapy and Oncology, 92(1), 4-14.
https://doi.org/10.1016/j.radonc.2009.04.014
16. Schwarz M, Van Gestel D, Tomsej M, Zhang L, Strojan P. VMAT in head and neck cancer: current practice and future directions. Radiother Oncol. 2019 Jan;130(1):1-12.
17. Bhide, S., & Nutting, C. (2010). Advances in radiotherapy for head and neck cancer. Oral Oncology, 46(6), 439-441.
https://doi.org/10.1016/j.oraloncology.2010.03.005
18. CM, N. (2011). Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol, 12, 127-136.
https://cir.nii.ac.jp/crid/1572261549213739264
19. Grégoire, V., Eisbruch, A., Hamoir, M., & Levendag, P. (2006). Proposal for the delineation of the nodal CTV in the node-positive and the post-operative neck. Radiotherapy and Oncology, 79(1), 15-20.
https://doi.org/10.1016/j.radonc.2006.03.009
20. Lefebvre, J. L., Rolland, F., Tesselaar, M., Bardet, E., Leemans, C. R., Geoffrois, L., ... & EORTC Head and Neck Cancer Cooperative Group and the EORTC Radiation Oncology Group. (2009). Phase 3 randomized trial on larynx preservation comparing sequential vs alternating chemotherapy and radiotherapy. Journal of the National Cancer Institute, 101(3), 142-152.
https://doi.org/10.1093/jnci/djn460
21. Beitler JJ, et al. Final results of local control and functional outcomes of RTOG 91-22. Head Neck. 2017 Apr;39(4):652–8.
22. Schwartz DL, et al. Adaptive radiotherapy for head and neck cancer—dose and volume changes during radiation. Int J Radiat Oncol Biol Phys. 2012 Mar 1;83(4):986-93.
23. Seiwert, T. Y., Salama, J. K., & Vokes, E. E. (2007). The concurrent chemoradiation paradigm—general principles. Nature Clinical Practice Oncology, 4(2), 86-100.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
