BACKGROUND: Depending on the extent of disease, squamous cell carcinoma (SCC) of the glottis is managed with surgery, radiotherapy (RT), or a combination of these modalities. Patients with advanced disease may receive concomitant chemotherapy in conjunction with definitive or postoperative RT. METHODS: The treatment policies of the University of Florida and patient outcomes are reviewed. RESULTS: The likelihood of cure after RT for carcinoma in situ (Tis) to T2 glottic SCC varies from 70% to 94% depending on tumor stage. Consideration should be given to adding weekly cisplatin for patients with T2b SCC because of the high local recurrence rate after RT alone. The probability of cure is about 65% to 80% for select low-volume (≤ 3.5 cc) T3 to T4 glottic SCC after RT. These patients should be considered for concomitant weekly cisplatin. Higher-volume tumors, particularly those with airway compromise, should be treated with laryngectomy and postoperative RT. CONCLUSION: Definitive RT is an excellent treatment for select patients with laryngeal cancer.
BACKGROUND: Depending on the extent of disease, squamous cell carcinoma (SCC) of the glottis is managed with surgery, radiotherapy (RT), or a combination of these modalities. Patients with advanced disease may receive concomitant chemotherapy in conjunction with definitive or postoperative RT. METHODS: The treatment policies of the University of Florida and patient outcomes are reviewed. RESULTS: The likelihood of cure after RT for carcinoma in situ (Tis) to T2 glottic SCC varies from 70% to 94% depending on tumor stage. Consideration should be given to adding weekly cisplatin for patients with T2b SCC because of the high local recurrence rate after RT alone. The probability of cure is about 65% to 80% for select low-volume (≤ 3.5 cc) T3 to T4 glottic SCC after RT. These patients should be considered for concomitant weekly cisplatin. Higher-volume tumors, particularly those with airway compromise, should be treated with laryngectomy and postoperative RT. CONCLUSION: Definitive RT is an excellent treatment for select patients with laryngeal cancer.
Authors: Huaising C Ko; Paul M Harari; Shuai Chen; Aaron M Wieland; Menggang Yu; Andrew M Baschnagel; Randall J Kimple; Matthew E Witek Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-11-01 Impact factor: 6.223