Salil Vengalil1,2, Meredith E Giuliani1, Shao Hui Huang1, Andrea McNiven3, Yuyao Song4, Wei Xu4, Biu Chan1, Andrew Hope1, John Cho1, Andrew Bayley1, Jolie Ringash1, David Goldstein5, Albiruni Razak6, Jonathan Irish5, Ralph Gilbert5, Patrick Gullane5, John Waldron1, John Kim1, Brian O'Sullivan1. 1. Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. 2. Department of Clinical Oncology, Royal Stoke University Hospital, University Hospital North Midlands NHS Trust, Stoke-on-Trent, United Kingdom. 3. Department of Radiation Physics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. 4. Department of Biostatistics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. 5. Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada. 6. Division of Medical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND: The purpose of this study was to determine the clinical outcomes of T4 laryngeal cancers. METHODS: T4 laryngeal cancers treated with curative intent from January 2003 to December 2010 were analyzed. Outcomes were evaluated in both primary radiotherapy (+/- chemotherapy) (RT/CRT) and primary surgery cohorts. RESULTS: Among the 65 primary RT/CRT and 42 primary surgery patients included, median follow-up was 4.4 years. There was a trend for improved locoregional control with surgery (74% vs 88%; p = .08). In the RT/CRT group the 3-year laryngectomy-free survival was 67%. The 2-year gastrostomy dependency rate was 23% with RT/CRT versus 6% with primary surgery (p = .07). Overall survival (OS) at 3 years was significantly lower in the RT/CRT versus primary surgery group (41% vs 70%; p < .01). CONCLUSION: Laryngeal preservation is achieved in over two thirds of patients with primary RT/CRT. Patients with low volume minimal cartilage involvement T4 disease may be best suited to RT/CRT.
BACKGROUND: The purpose of this study was to determine the clinical outcomes of T4 laryngeal cancers. METHODS: T4 laryngeal cancers treated with curative intent from January 2003 to December 2010 were analyzed. Outcomes were evaluated in both primary radiotherapy (+/- chemotherapy) (RT/CRT) and primary surgery cohorts. RESULTS: Among the 65 primary RT/CRT and 42 primary surgery patients included, median follow-up was 4.4 years. There was a trend for improved locoregional control with surgery (74% vs 88%; p = .08). In the RT/CRT group the 3-year laryngectomy-free survival was 67%. The 2-year gastrostomy dependency rate was 23% with RT/CRT versus 6% with primary surgery (p = .07). Overall survival (OS) at 3 years was significantly lower in the RT/CRT versus primary surgery group (41% vs 70%; p < .01). CONCLUSION: Laryngeal preservation is achieved in over two thirds of patients with primary RT/CRT. Patients with low volume minimal cartilage involvement T4 disease may be best suited to RT/CRT.
Authors: Pavel Dulguerov; Martina A Broglie; Guido Henke; Marco Siano; Paul Martin Putora; Christian Simon; Daniel Zwahlen; Gerhard F Huber; Giorgio Ballerini; Lorenza Beffa; Roland Giger; Sacha Rothschild; Sandro V Negri; Olgun Elicin Journal: Front Oncol Date: 2019-10-24 Impact factor: 6.244