Racial Disparities in the Use of Voice Preservation Therapy for Locally Advanced Laryngeal Cancer

Abstract Introduction Despite the acceptance of concomitant chemoradiation (CRT) as an alternative to total laryngectomy (TL) in locally advanced laryngeal cancer (LALC), laryngeal preservation is sparingly recommended in developing countries. We report on prognostic factors and survival in T3/T4 laryngeal cancer treated with concomitant CRT at Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH and RC) to provide comparison with other geographic locations. Material and Methods During the period November 2003-April 2009, 101 patients with biopsy proven untreated LALC underwent concurrent CRT treatment at SKMCH and RC. According to AJCC staging system (6th edition) 41 had T3 and 60 patients had T4 disease. Radiation dose to the larynx was 70 Gy in 35 fractions with concomitant cisplatin. Induction chemotherapy was given to 42 patients. Thirty-one patients required tracheotomy either before or during concomitant CRT. Results Actuarial overall survival and laryngectomy free survival (LFS) for the whole group at 5 years were 54% (95% CI; 48-60) and 47% (95% CI; 42-52) respectively. Median LFS was 4.17 years. On univariate analysis patients with T4 tumors (p = 0.04), positive neck nodal disease (p = 0.02), supraglottic site (p = 0.02) and tracheotomy (0.009) had a significantly inferior LFS. Multivariate analysis showed tracheotomy to be the only factor significantly (p = 0.03) related to a higher risk of failure for LFS. Conclusion Survival rates for LALC treated with concomitant CRT in our institution are acceptable. Our study supports the use of TL in patients with compromised airways that require tracheotomy as outcome with concomitant CRT is poor.

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Hemoglobin change, not hemoglobin concentration, has the predictive value in postoperative radiotherapy for locally advanced laryngeal cancer

European Journal of Cancer ◽

10.1016/s0959-8049(01)80861-3 ◽

2001 ◽

Vol 37 ◽

pp. S102

Author(s):

T. Rutkowski ◽

R. Suwinski ◽

A. Sowa ◽

M. Suwinska-Gawkowska

Keyword(s):

Laryngeal Cancer ◽

Predictive Value ◽

Postoperative Radiotherapy ◽

Locally Advanced ◽

Hemoglobin Concentration

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Chondronecrosis versus recurrence: FDG PET/CT solves the dilemma in a case of locally advanced laryngeal cancer treated with definitive radiotherapy

Indian Journal of Nuclear Medicine ◽

10.4103/0972-3919.119530 ◽

2013 ◽

Vol 28 (3) ◽

pp. 191

Author(s):

Venkatesh Rangarajan ◽

AmeyaD Puranik ◽

NilenduC Purandare ◽

Archi Agrawal ◽

Sneha Shah

Keyword(s):

Laryngeal Cancer ◽

Fdg Pet ◽

Locally Advanced ◽

Definitive Radiotherapy ◽

Pet Ct ◽

Fdg Pet Ct

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Adjuvant role of radiation therapy for locally advanced laryngeal cancer without pathological lymph node metastasis

Acta Oto-Laryngologica ◽

10.3109/00016489.2016.1146827 ◽

2016 ◽

Vol 136 (7) ◽

pp. 703-710 ◽

Cited By ~ 2

Author(s):

Sung Hee Kim ◽

Yoon Se Lee ◽

Minsu Kwon ◽

Ji Won Kim ◽

Jong-Lyel Roh ◽

...

Keyword(s):

Radiation Therapy ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Laryngeal Cancer ◽

Locally Advanced ◽

Node Metastasis ◽

Pathological Lymph Node Metastasis

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Laryngeal preservation in cases of advanced laryngeal cancer treated with platinum based induction chemotherapy befire local treatment

The Journal of Laryngology & Otology ◽

10.1017/s0022215100117840 ◽

1991 ◽

Vol 105 (11) ◽

pp. 930-933 ◽

Cited By ~ 11

Author(s):

A. Nikolaou ◽

G. Fountzilas ◽

P. Kosmidis ◽

C. Banis ◽

K. Sobolos ◽

...

Keyword(s):

Radiation Therapy ◽

Induction Chemotherapy ◽

Laryngeal Cancer ◽

Performance Status ◽

Locally Advanced ◽

Local Treatment ◽

Locoregional Treatment ◽

Large Groups ◽

Disease Free

AbstractIn this study we analyse our preliminary results after treating 28 patients with locally advanced laryngeal cancer with platinum based induction chemotherapy followed by radiation therapy or surgery.The median age of our patients was 60 (46–75) years and median performance status was 80 (60–100). In 18 of the 28 patients locoregional treatment was radiation therapy with an overall response of 94.4 per cent.After a median follow-up of 26 (15–40) months 39.3 per cent of the whole group of patients are alive and disease-free and six (21.4 per cent) patients are alive and disease-free preserving their larynx.We conclude that although more extensive studies with large groups of patients and longer follow-up is needed to reach definite conclusions, it seems that platinum based induction chemotheraophy can be used successfully in locally advanced laryngeal cancer followed by radiotherapy. In those cases who respond well. the patient's larynx is preserved without compromizing the overall survival.

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Supracricoid partial laryngectomy: an alternative to total laryngectomy for locally advanced laryngeal cancers

The Journal of Laryngology & Otology ◽

10.1017/s0022215108001862 ◽

2008 ◽

Vol 122 (11) ◽

pp. 1219-1223 ◽

Cited By ~ 6

Author(s):

E Soudry ◽

Y Marmor ◽

A Hazan ◽

S Marx ◽

R Sadov ◽

...

Keyword(s):

Laryngeal Cancer ◽

Medical Records ◽

Total Laryngectomy ◽

Locally Advanced ◽

Partial Laryngectomy ◽

Oncological Safety ◽

Supracricoid Partial Laryngectomy ◽

Laryngeal Tumours ◽

Feasible Option

AbstractObjectives:The management of advanced laryngeal cancer has evolved in the last century, from total laryngectomy to chemoradiation. The aim of this study was to examine our experience with supracricoid partial laryngectomy as a possible solution for patients with advanced laryngeal tumours, with a focus on the oncological safety of the procedure and the functionality of the preserved larynges.Study design:We reviewed the medical records of patients with laryngeal cancer who had undergone primary or salvage supracricoid partial laryngectomy at our department between 1998 and 2004.Results:Twenty-three patients treated with supracricoid partial laryngectomy for endolaryngeal squamous cell carcinoma were identified. Median follow-up time was 35 months. Twelve patients had advanced laryngeal tumours. Eight patients were radiation failures. These factors were not associated with increased local recurrence or with decreased survival.Conclusion:Supracricoid partial laryngectomy appears to be a feasible option for the treatment of laryngeal tumours, even in the advanced stage or after failure of radiation therapy.

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