Anal Surgery: Organ and Function Preservation

The non-surgical management of head and neck cancer has changed over the last two decades with more emphasis given now to organ preservation and post-treatment organ function. These two concepts do not necessarily go hand in hand but preserving an organ without preserving its function is pointless. In this period, for some head and neck cancers subsites, for example, oropharynx, the treatment model has moved away from primary surgery followed by planned, adjuvant radiotherapy, to one of primary chemoradiotherapy with the objective of greater organ and function preservation. This change in management strategy may be coming under further review now, with the introduction of transoral robotic surgery (TORS), where the treatment model may revert back to primary surgery with the question raised, whether highly selective TORS followed by highly selective adjuvant radiotherapy using the newer radiation technologies and techniques with intensity-modulated radiotherapy or tomotherapy, with or without chemotherapy might optimize tumour control with minimal long-term morbidity.

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Locally advanced head and neck cancer: combined chemotherapy and radical radiation therapy for organ and function preservation (interim report).

Radiology ◽

10.1148/radiology.204.1.9205248 ◽

1997 ◽

Vol 204 (1) ◽

pp. 207-210 ◽

Cited By ~ 1

Author(s):

A Y Cheung ◽

J Rinehart ◽

T Ruff

Keyword(s):

Radiation Therapy ◽

Head And Neck Cancer ◽

Head And Neck ◽

Locally Advanced ◽

Advanced Head ◽

Combined Chemotherapy ◽

Interim Report ◽

Function Preservation ◽

Radical Radiation ◽

And Function

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Comparative Treatment Outcome in T3N0 Glottic Cancer With and Without Vocal Fold Fixation Receiving Radiation Therapy and Concurrent Low-Dose Intra-Arterial Cisplatin Infusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211047789 ◽

2021 ◽

pp. 000348942110477

Author(s):

Takeharu Ono ◽

Norimitsu Tanaka ◽

Shun-ichi Chitose ◽

Syuichi Tanoue ◽

Takashi Kurita ◽

...

Keyword(s):

Vocal Fold ◽

Locally Advanced ◽

Survival Rates ◽

Glottic Cancer ◽

Cancer Specific Survival ◽

Laryngeal Function ◽

Free Survival ◽

Function Preservation ◽

Grade 3 ◽

And Function

Objectives: Selective radiotherapy and concomitant intra-arterial cisplatin infusion (m-RADPLAT) with a lower cisplatin dosage have been performed for organ and function preservation in patients with locally advanced squamous cell carcinoma of the larynx (SCC-L), and results showing a lower rate of adverse events have been reported. This study evaluated the treatment outcomes of patients with T3N0 glottic SCC-L with or without vocal fold fixation (VFF) who were treated with m-RADPLAT. Methods: We retrospectively reviewed the data of 33 patients with T3N0 SCC-L who received m-RADPLAT. Results: The vocal fold in patients with VFF 3 months after completing m-RADPLAT resumed normal movement in 15 patients (83%) and persisted fixation in 3 (17%). The 3-year local control, laryngeal cancer-specific survival, and overall survival rates of patients with or without VFF were 88.9% and 86.7%, 94.1% and 93.3%, and 88.9% and 86.7%, respectively. Additionally, the 3-year freedom from laryngectomy, laryngectomy-free survival, and laryngo-esophageal dysfunction-free survival rates of patients with or without VFF were 94.4% and 86.7%, 88.9% and 73.3%, and 83.3% and 73.3%, respectively. Grade 3 or higher toxicities were observed in all patients: leukopenia in 4 patients (12%), neutropenia in 5 (15%), anemia in 2 (6%), thrombocytopenia in 3 (9%), and mucositis in 2 (6%). Conclusions: This study demonstrated that m-RADPLAT yielded VFF improvement and a favorable survival while maintaining laryngeal function not only in patients with T3N0 glottic SCC-L without VFF but also in patients with VFF.

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