PURPOSE: The aim of this study was to evaluate the efficacy of adjuvant radiotherapy after transoral laser microsurgery for advanced recurrent head-and-neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS: Between 1988 and 2000, 37 patients with advanced local recurrences (23 local and 14 locoregional recurrences) of HNSCC without distant metastases were treated in curative intent with organ-preserving transoral laser microsurgery and adjuvant radiotherapy (before 1994 split-course radiotherapy with carboplatinum, after 1994 conventional radiotherapy). Initial therapy of the primary (8.1% oral cavity, 35.1% oropharynx, 13.5% hypopharynx, and 43.3% larynx) before relapse was organ-preserving transoral laser microsurgery without any adjuvant therapy. RESULTS: After a median follow-up of 124 months, the 5-year overall survival rate was 21.3%, the loco-regional control rate 48.3%, respectively. In multivariate analysis, stage of original primary tumor (Stage I/II vs. Stage III/IV), and patient age (<58 years vs. >or=58 years) showed statistically significant impact on prognosis. In laryngeal cancer, larynx preservation rate after treatment for recurrent tumor was 50% during follow-up. CONCLUSION: Our data show that organ-preserving transoral laser microsurgery followed by adjuvant radiotherapy is a curative option for patients who have advanced recurrence after transoral laser surgery and is an alternative to radical treatment.
PURPOSE: The aim of this study was to evaluate the efficacy of adjuvant radiotherapy after transoral laser microsurgery for advanced recurrent head-and-neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS: Between 1988 and 2000, 37 patients with advanced local recurrences (23 local and 14 locoregional recurrences) of HNSCC without distant metastases were treated in curative intent with organ-preserving transoral laser microsurgery and adjuvant radiotherapy (before 1994 split-course radiotherapy with carboplatinum, after 1994 conventional radiotherapy). Initial therapy of the primary (8.1% oral cavity, 35.1% oropharynx, 13.5% hypopharynx, and 43.3% larynx) before relapse was organ-preserving transoral laser microsurgery without any adjuvant therapy. RESULTS: After a median follow-up of 124 months, the 5-year overall survival rate was 21.3%, the loco-regional control rate 48.3%, respectively. In multivariate analysis, stage of original primary tumor (Stage I/II vs. Stage III/IV), and patient age (<58 years vs. >or=58 years) showed statistically significant impact on prognosis. In laryngeal cancer, larynx preservation rate after treatment for recurrent tumor was 50% during follow-up. CONCLUSION: Our data show that organ-preserving transoral laser microsurgery followed by adjuvant radiotherapy is a curative option for patients who have advanced recurrence after transoral laser surgery and is an alternative to radical treatment.
Authors: Dana M Hartl; Alfio Ferlito; Carl E Silver; Robert P Takes; Sandro J Stoeckli; Carlos Suárez; Juan P Rodrigo; Andreas M Sesterhenn; Carl H Snyderman; David J Terris; Eric M Genden; Alessandra Rinaldo Journal: Eur Arch Otorhinolaryngol Date: 2011-05-12 Impact factor: 2.503
Authors: Arno Olthoff; Andreas Ewen; Hendrik Andreas Wolff; Robert Michael Hermann; Hilke Vorwerk; Andrea Hille; Ralph Rödel; Clemens F Hess; Wolfgang Steiner; Olivier Pradier; Hans Christiansen Journal: Strahlenther Onkol Date: 2009-05-15 Impact factor: 3.621
Authors: Samir H Patel; Michael L Hinni; Richard E Hayden; William W Wong; Amylou C Dueck; Matthew A Zarka; Kelly K Curtis; Michele Y Halyard Journal: Head Neck Date: 2013-03-26 Impact factor: 3.147
Authors: H A Wolff; C R M Wolff; C F Hess; K Jung; S Sennhenn-Kirchner; M Hinterthaner; A Müller-Dornieden; W Körber; K Marten-Engelke; R Roedel; H Christiansen; C Engelke Journal: Strahlenther Onkol Date: 2013-07-12 Impact factor: 3.621