Gen Suzuki1, Hideya Yamazaki2, Etsuyo Ogo1, Toshi Abe1, Hidehiro Eto1, Koichiro Muraki1, Chikayuki Hattori1, Hirohito Umeno3, Norimitsu Tanaka1, Toshiaki Tanaka4, Satoaki Nakamura5, Ken Yoshida6. 1. Department of Radiology, Kurume University, Fukuoka, Japan. 2. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan hideya10@hotmail.com. 3. Department of Oto-rhino-laryngology, Kurume University, Fukuoka, Japan. 4. Department of Surgery, Kurume University, Fukuoka, Japan. 5. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. 6. Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan.
Abstract
AIM: To identify predisposing factors for larynx preservation strategies using non-surgical multimodality approaches. PATIENTS AND METHODS: We retrospectively reviewed the records of 48 patients with T3-4 diseases (14 larynx, 19 hypopharynx, 15 cervical esophagus). Out of 48 patients, 33 refused surgery, and 15 were deemed inoperable, and a total of 25 were graded as T3 and 23 as T4. A total of 24 patients received induction chemotherapy. Radiotherapy was administered at a median dose of 61 Gy (range, 30-71 Gy). Concurrent chemotherapy was administered to all patients: intra-arterial infusion in 21, systemic infusion in 24, or both in 3. RESULTS: Thirty-seven cases (77%) achieved a complete response. The 3-year local control, progression-free survival (PFS), overall survival (OS), and laryngeal preservation rates were 56%, 48%, 56%, and 73%, respectively. Tumor location, nodal involvement, and pre-treatment serum hemoglobin values were identified as predisposing factors for local control, PFS, and OS. Multivariate analysis revealed that the pre-treatment serum hemoglobin levels and tumor location were significant prognostic factors for PFS. CONCLUSION: Tumor location and pre-treatment hemoglobin levels are important prognostic factors for PFS for non-surgical multimodal organ preservation treatment. Copyright
AIM: To identify predisposing factors for larynx preservation strategies using non-surgical multimodality approaches. PATIENTS AND METHODS: We retrospectively reviewed the records of 48 patients with T3-4 diseases (14 larynx, 19 hypopharynx, 15 cervical esophagus). Out of 48 patients, 33 refused surgery, and 15 were deemed inoperable, and a total of 25 were graded as T3 and 23 as T4. A total of 24 patients received induction chemotherapy. Radiotherapy was administered at a median dose of 61 Gy (range, 30-71 Gy). Concurrent chemotherapy was administered to all patients: intra-arterial infusion in 21, systemic infusion in 24, or both in 3. RESULTS: Thirty-seven cases (77%) achieved a complete response. The 3-year local control, progression-free survival (PFS), overall survival (OS), and laryngeal preservation rates were 56%, 48%, 56%, and 73%, respectively. Tumor location, nodal involvement, and pre-treatment serum hemoglobin values were identified as predisposing factors for local control, PFS, and OS. Multivariate analysis revealed that the pre-treatment serum hemoglobin levels and tumor location were significant prognostic factors for PFS. CONCLUSION:Tumor location and pre-treatment hemoglobin levels are important prognostic factors for PFS for non-surgical multimodal organ preservation treatment. Copyright