PURPOSE: To compare toxicity, survival and laryngeal preservation rate after radiotherapy alone (RR), radiotherapy after supraglottic horizontal laryngectomy (SHLR) and radiotherapy after total laryngectomy (TLR) for advanced supraglottic laryngeal cancer. MATERIALS AND METHODS: From 1984 to 2012, 532 patients (pts) were treated in our Department: 273 were potentially fit for conservative surgery (Group I) and 259 were not amenable to partial surgery (Group II). RESULTS: A younger age (p = 0.005), a better performance status (p < 0.001), the absence of comorbidities (p < 0.001) and the absence of nodal involvement (p = 0.006) favorably impacted on overall survival. More high-grade mucositis (p = 0.009), mild dysphagia (p < 0.001) and mild xerostomia (p < 0.001) were found in RR group; surgical patients had more edema of neck (p = 0.009) and skin toxicity (p = 0.008). Group I No differences in local, nodal and distant recurrences and in number of rescue laryngectomies were observed. The disease characteristics (T, N and stage) but not the treatment modality impacted on disease-free survival (DFS). Group II There was an higher number of local (p = 0.013) and nodal (p = 0.022) recurrences after RR. DFS (p = 0.01) was longer after TLR. No differences in DFS between TLR patients and RR patients who underwent radio-chemotherapy were found. CONCLUSION: In Group I, RR results in a local-regional control and organ preservation comparable to surgical treatments, with only slight increase of late mild xerostomia and dysphagia. In Group II RR was less effective than TLR, with a significantly worse DFS. The use of concurrent radical radio-chemotherapy seems to provide comparable loco-regional control to TLR.
PURPOSE: To compare toxicity, survival and laryngeal preservation rate after radiotherapy alone (RR), radiotherapy after supraglottic horizontal laryngectomy (SHLR) and radiotherapy after total laryngectomy (TLR) for advanced supraglottic laryngeal cancer. MATERIALS AND METHODS: From 1984 to 2012, 532 patients (pts) were treated in our Department: 273 were potentially fit for conservative surgery (Group I) and 259 were not amenable to partial surgery (Group II). RESULTS: A younger age (p = 0.005), a better performance status (p < 0.001), the absence of comorbidities (p < 0.001) and the absence of nodal involvement (p = 0.006) favorably impacted on overall survival. More high-grade mucositis (p = 0.009), mild dysphagia (p < 0.001) and mild xerostomia (p < 0.001) were found in RR group; surgical patients had more edema of neck (p = 0.009) and skin toxicity (p = 0.008). Group I No differences in local, nodal and distant recurrences and in number of rescue laryngectomies were observed. The disease characteristics (T, N and stage) but not the treatment modality impacted on disease-free survival (DFS). Group II There was an higher number of local (p = 0.013) and nodal (p = 0.022) recurrences after RR. DFS (p = 0.01) was longer after TLR. No differences in DFS between TLR patients and RR patients who underwent radio-chemotherapy were found. CONCLUSION: In Group I, RR results in a local-regional control and organ preservation comparable to surgical treatments, with only slight increase of late mild xerostomia and dysphagia. In Group II RR was less effective than TLR, with a significantly worse DFS. The use of concurrent radical radio-chemotherapy seems to provide comparable loco-regional control to TLR.
Authors: Robert Haddad; Anne O'Neill; Guilherme Rabinowits; Roy Tishler; Fadlo Khuri; Douglas Adkins; Joseph Clark; Nicholas Sarlis; Jochen Lorch; Jonathan J Beitler; Sewanti Limaye; Sarah Riley; Marshall Posner Journal: Lancet Oncol Date: 2013-02-13 Impact factor: 41.316
Authors: Giuseppe Mercante; Alberto Grammatica; Paolo Battaglia; Giovanni Cristalli; Raul Pellini; Giuseppe Spriano Journal: Otolaryngol Head Neck Surg Date: 2013-08-06 Impact factor: 3.497
Authors: Jimmy J Caudell; Philip E Schaner; Ruby F Meredith; Julie L Locher; Lisle M Nabell; William R Carroll; J Scott Magnuson; Sharon A Spencer; James A Bonner Journal: Int J Radiat Oncol Biol Phys Date: 2008-07-16 Impact factor: 7.038
Authors: Arlene A Forastiere; Qiang Zhang; Randal S Weber; Moshe H Maor; Helmuth Goepfert; Thomas F Pajak; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; Wade Thorstad; Henry Wagner; John F Ensley; Jay S Cooper Journal: J Clin Oncol Date: 2012-11-26 Impact factor: 44.544
Authors: Michael L Hinni; John R Salassa; David G Grant; Bruce W Pearson; Richard E Hayden; Alexios Martin; Hans Christiansen; Bruce H Haughey; Brian Nussenbaum; Wolfgang Steiner Journal: Arch Otolaryngol Head Neck Surg Date: 2007-12