Radiation Therapy for Squamous Cell Carcinoma of the Tonsillar Region: A Preferred Alternative to Surgery?

2000 ◽  
Vol 18 (11) ◽  
pp. 2219-2225 ◽  
Author(s):  
William M. Mendenhall ◽  
Robert J. Amdur ◽  
Scott P. Stringer ◽  
Douglas B. Villaret ◽  
Nicholas J. Cassisi
Keyword(s):  
Multivariate Analysis ◽  
Neck Dissection ◽  
Local Control ◽  
Early Stage ◽  
Survival Rates ◽  
Tumor Stage ◽  
Late Complications ◽  
Disease Stage ◽  
Fractionation Schedule ◽  
Cause Specific Survival

PURPOSE: There are no definitive randomized studies that compare radiotherapy (RT) with surgery for tonsillar cancer. The purpose of this study was to evaluate the results of RT alone and RT combined with a planned neck dissection for carcinoma of the tonsillar area and to compare these data with the results of treatment with primary surgery.PATIENTS AND METHODS: Four hundred patients were treated between October 1964 and December 1997 and observed for at least 2 years. One hundred forty-one patients underwent planned neck dissection, and 18 patients received induction (17 patients) or concomitant (one patient) chemotherapy.RESULTS: Five-year local control rates, by tumor stage, were as follows: T1, 83%; T2, 81%; T3, 74%; and T4, 60%. Multivariate analysis revealed that local control was significantly influenced by tumor stage (P = .0001), fractionation schedule (P = .0038), and external beam dose (P = .0227). Local control after RT for early-stage cancers was higher for tonsillar fossa/posterior pillar cancers than for those arising from the anterior tonsillar pillar. Five-year cause-specific survival rates, by disease stage, were as follows: I, 100%; II, 86%; III, 82%; IVa, 63%; and IVb, 22%. Multivariate analysis revealed that cause-specific survival was significantly influenced by overall stage (P = .0001), planned neck dissection (P = .0074), and histologic differentiation (P = .0307). The incidence of severe late complications after treatment was 5%.CONCLUSION: RT alone or combined with a planned neck dissection provides cure rates that are as good as those after surgery and is associated with a lower rate of severe complications.

Radiotherapy for Medically Inoperable Non-Small Cell Lung Cancer at Clinical Stage I and II

2003 ◽  
Vol 89 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Kazunari Yamada ◽  
Toshinori Soejima ◽  
Yosuke Ota ◽  
Ryohei Sasaki ◽  
Eisaku Yoden ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Local Control ◽  
Significant Influence ◽  
Small Cell Lung Carcinoma ◽  
Clinical Stage ◽  
Survival Rates ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Cause Specific Survival

We reviewed the records of 36 patients with medically inoperable stage l-ll non-small cell lung carcinoma who were treated with radiotherapy. The median dose to the target was 60 Gy with conventional fractionation. Fifteen patients were treated without elective irradiation fields, while the remaining 21 were treated with extended fields including elective mediastinal regional lymph nodes. The overall survival rates at three and five years were 32.3% and 18.8%, the cause-specific survival rates were 40.9% and 27.3%, and the local control rates were 31.7% and 23.8%, respectively. In multivariate analysis the radiation dose had a marginally significant influence on the cause-specific survival, while tumor size had a significant influence on the local control rate. Only one patient had relapse in the regional mediastinal lymph nodes as the only site of metastasis. We conclude that the dose used in the present study is inadequate and recommend that further efforts be made to improve local control by dose escalation within a small target volume.

scholarly journals Management and prognosis of cancers in the accessory parotid gland

2018 ◽  
Vol 46 (12) ◽  
pp. 4930-4933 ◽  
Author(s):  
Xiaoxue Han ◽  
Xifeng Zhang ◽  
Yuqin Gao ◽  
Pai Pang ◽  
Fayu Liu ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Neck Dissection ◽  
Facial Paralysis ◽  
Medical Center ◽  
Survival Rates ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Selective Neck Dissection ◽  
High Survival ◽  
Accessory Parotid Gland

Objective This study was performed to analyze the clinical management of accessory parotid gland (APG) cancer and possible risk factors for disease-related death. Methods Patients diagnosed with primary APG cancers in the largest medical center in Northeast China were enrolled from January 1990 to December 2016. Results All 43 patients underwent resection of the tumors and superficial parotid gland by a standard Blair incision. Seven (16.3%) patients also required selective neck dissection. The most common lesion was mucoepidermoid carcinoma. Temporary facial paralysis occurred in 11 (25.6%) patients, and permanent facial paralysis occurred in 3 (7.0%) patients because of surgical resection of the facial nerve, which was involved with the tumor. The 5- and 10-year disease-specific survival rates were 86.0% and 66.0%, respectively. The tumor stage, neck status, neck dissection, and tumor grade were significantly associated with disease-related death, but only the tumor grade was an independent risk factor. Conclusion Superficial parotidectomy is a reliable surgical procedure associated with a high survival rate and low morbidity in treating APG cancers. The tumor grade is the key prognostic factor.

Synovial sarcoma: Retrospective analysis of treatment outcome and prognostic factors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20517-20517
Author(s):  
M. A. Memon ◽  
A. A. Allam ◽  
A. M. El-Enbaby ◽  
M. El-Sebaie ◽  
Y. M. Khafaga ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Treatment Outcome ◽  
Prognostic Factors ◽  
Synovial Sarcoma ◽  
Surgical Resection ◽  
Local Control ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Tumor Stage ◽  
Stage Iii

20517 Introduction and Objectives: Synovial Sarcoma (SS) account for approximately 10 % of soft tissue sarcoma. Despite numerous case reports and several relatively large series, debate still exists about the prognostic factors for this disease, the biologic behavior and role of adjuvant chemotherapy. The purpose of this study is to analyze the variable prognostic factors that may affect the treatment outcome in patients with SS. Patient and Methods: Sixty-six patients with SS (36 males and 30 females) were seen in institution between January 1985 and December 2000. Median age at diagnosis was 29 years. Site of involvement include, lower extremities 43/66 cases; (65%), upper extremity 16/66 (24%), trunk 3/66 (5%), others 4/66 (include larynx, thyroid, neck, and hypopharynx).Tumor size: = 10 cm 42/66 (64%), = 10 cm 24/66 (36%). Patients with stage III and IV disease represented 58% of all patients (38/66), stage I and II 42%(28/66). All patients underwent surgery and adequate resection margins(= 2 cm) were achieved in 52% of cases. Histopathology: Biphasic 36/66, Monophasic 16/66, spindle cell 12/66 and not otherwise specified 2/66. Radiation therapy was given 44/66 cases (67%). Chemotherapy was delivered to 11/66 patients (17%). Results: With a median follow up of 50 months, the 5-year overall survival (OS) for all patients was 45%, while the 5- year relapse free survival (RFS) for patients treated with radical intent was 32%. Prognostic factors that significantly affected OS on univariate analysis were tumor size (≤ 10 cm vs > 10cm), tumor stage (stages I and II vs stage III), adequacy of surgical resection and local control. On multivariate analysis, tumor size and local control were the only independent factors that did affect OS. For RFS, sex, tumor size, tumor grade, tumor stage, and adequacy of surgical resection were the prognostic factors of significance on univariate. Tumor stage and sex were the only independent prognostic factors of significance on multivariate analysis for RFS. Conclusion: Tumor size, stage, grade, and adequacy of surgical resection are the main prognostic factors affecting OS and RFS. These parameters can help to identify the high risk patient who may qualify for aggressive treatment. No significant financial relationships to disclose.

Cholangiocarcinomas: A study of patient and disease characteristics and the potential use of tumor molecular profiling.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 270-270
Author(s):  
Petra Prins ◽  
Jeff Riskin ◽  
Karina Charipova ◽  
Michelle Dea ◽  
Ben Furlong ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Early Stage ◽  
Treatment Options ◽  
Survival Rates ◽  
Molecular Profiling ◽  
Detection Methods ◽  
Disease Stage ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Clinical Records

270 Background: There are approximately 12,000 new cases of cholangiocarcinoma in the US annually and, as for most GI cancers, the incidence is rising each year. Unfortunately treatment options are limited and surgery is only a possible curative option if the disease is diagnosed at an early stage (5 yr. survival, 20-30 %). Molecular profiling may play a crucial role in the discovery of new (early) biomarkers and treatment options for cholangiocarcinoma. Methods: Clinical records 104 cholangiocarcinoma patients (pts) at the Lombardi Comprehensive Cancer Center were reviewed. Only pts that had received surgical therapy were eligible for study. Variables collected included pt demographics, initial disease stage, tumor differentiation, and clinical (pre-existing) conditions. Tumor recurrence and pt survival from time of surgery was evaluated. Molecular profiling data was analyzed when present. Results: In our cohort we identified 41 pts with cholangiocarcinoma who underwent surgery at LCCC. Clinical data was as follows: 20 males and 21 females. Average BMI at diagnosis was 25.8 kg/m2. Twelve pts had extrahepatic cancer, 20 intrahepatic, 5 gallbladder, 3 Hilar and 1 combined hepatocellular and bile duct cancer. Most tumors were stage T2 or T3 (61%), and were moderately (71%) to poorly differentiated (22%). Vascular or perineural invasion was identified in 46% of cases. Thirty-four percent and 37% had diabetes and hyperlipidemia, respectively. Tumor recurrence had occurred in 13 cases (32%), and median time to recurrence was 8.5 months (m). Median OS from surgery was 10.5 m (to date, 4 pts > 36 m). Molecular profiles were obtained in 5 cases. Most frequently observed genetic mutations were related to tumor suppression (PTEN, 4 cases) and DNA synthesis, repair, and regulation (TOP2A [3x], TOPO1 [2x], TP53 [2x]). Conclusions: Five-year survival rates for cholangiocarcinomas are low. To improve outcomes, improved early detection methods and better treatment options are urgently needed. Increasing the frequency of molecular profiling can result in new prognostic biomarkers as well as the potential for new treatment ideas.

scholarly journals Effects of Different Treatment Strategies and Tumor Stage on Survival of Patients with Advanced Laryngeal Carcinoma: A 15-Year Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Nima Daneshi ◽  
Mohammad Fararouei ◽  
Mohammad Mohammadianpanah ◽  
Mohammad Zare-Bandamiri ◽  
Somayeh Parvin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Laryngeal Cancer ◽  
Treatment Strategy ◽  
Cox Regression ◽  
Survival Rates ◽  
Treatment Strategies ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Disease Stage ◽  
Cancer Management

Background. Laryngeal cancer is the second most common cancer in the head and neck. Since laryngeal cancer management is a complex process, there is still no standard strategy to treat this disease in order to increase the survival rate of the patients especially among those with advanced form of the disease. Methods. A cohort study was undertaken to analyze factors predicting survival of the patients in advanced stage laryngeal cancer in the Southern Iran among all patients newly diagnosed with laryngeal cancer between 2000 and 2015. Results. Data of a total number of 415 patients who have had been diagnosed with advanced laryngeal cancer during this period was used for analysis. The patients’ 1-, 3-, 5-, and 10-year survival rates were 81%, 62%, 53%, and 38%, respectively. Multivariable Cox regression analyses indicated a significant relationship between patients’ survival and age at diagnosis (P<0.001), disease stage (P=0.002), tumor grade (P=0.008), positive L. node (P=0.008), and type of treatment (P<0.001). As expected, treatment strategy was identified as the most effective factor in survival of the patients. According to the results, patients who undergone surgical treatment experienced a longer survival than those who received other treatments. Conclusion. This study showed that the survival of patients depends on several factors, among which, treatment strategy is the most important. Combination of total laryngectomy plus chemoradiation provides superior local control and better survival compared to either radiotherapy or chemoradiation in patients with advanced laryngeal cancer.

scholarly journals Progress and prospects of early detection in lung cancer

Open Biology ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. 170070 ◽  
Author(s):  
Sean Blandin Knight ◽  
Phil A. Crosbie ◽  
Haval Balata ◽  
Jakub Chudziak ◽  
Tracy Hussell ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Survival Rates ◽  
Case Series ◽  
Stage Iv ◽  
Small Cell ◽  
Stage I ◽  
Disease Stage ◽  
Molecular Stratification ◽  
The Uk

Lung cancer is the leading cause of cancer-related death in the world. It is broadly divided into small cell (SCLC, approx. 15% cases) and non-small cell lung cancer (NSCLC, approx. 85% cases). The main histological subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma, with the presence of specific DNA mutations allowing further molecular stratification. If identified at an early stage, surgical resection of NSCLC offers a favourable prognosis, with published case series reporting 5-year survival rates of up to 70% for small, localized tumours (stage I). However, most patients (approx. 75%) have advanced disease at the time of diagnosis (stage III/IV) and despite significant developments in the oncological management of late stage lung cancer over recent years, survival remains poor. In 2014, the UK Office for National Statistics reported that patients diagnosed with distant metastatic disease (stage IV) had a 1-year survival rate of just 15–19% compared with 81–85% for stage I.

scholarly journals Clinical Outcome of CT-Guided Stereotactic Ablative Brachytherapy for Unresectable Early Non-Small Cell Lung Cancer: A Retrospective, Multicenter Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhe Ji ◽  
Bin Huo ◽  
Shifeng Liu ◽  
Qinghua Liang ◽  
Chao Xing ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Chest Wall ◽  
Local Control ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Ct Guided ◽  
Early Stage Nsclc

ObjectiveTo analyze the efficacy and safety of low dose rate stereotactic ablative brachytherapy (L-SABT) for treatment of unresectable early-stage non-small cell lung cancer (NSCLC).MethodsData of patients with early-stage NSCLC who received CT-guided L-SABT (radioactive I-125 seeds implantation) at eight different centers from December 2010 to August 2020 were retrospectively analyzed. Treatment efficacy and complications were evaluated.ResultsA total of 99 patients were included in this study. Median follow-up duration was 46.3 months (6.1-119.3 months). The 1-year, 3-year, and 5-year local control rates were 89.1%, 77.5%, and 75.7%, respectively. The 1-year, 3-year, and 5-year overall survival rates were 96.7%, 70.1%, and 54.4%, respectively. Treatment failure occurred in 38.4% of patients. Local/regional recurrence, distant metastasis, and recurrence combined with metastasis accounted for 15.1%, 12.1%, and 11.1%, respectively. Pneumothorax occurred in 47 patients (47.5%) with 19 cases (19.2%) needing closed drainage. The only radiation-related adverse reaction was two cases of grade 2 radiation pneumonia. KPS 80–100, T1, the lesion was located in the left lobe, GTV D90 ≥150 Gy and the distance between the lesion and chest wall was &lt; 1 cm, were associated with better local control (all P &lt; 0.05); on multivariate analysis KPS, GTV D90, and the distance between the lesion and chest wall were independent prognostic factors for local control (all P &lt; 0.05). KPS 80–100, T1, GTV D90 ≥150 Gy, and the distance between the lesion and chest wall was &lt; 1 cm were also associated with better survival (all P &lt; 0.05); on multivariate analysis KPS, T stage, and GTV D90 were independent prognostic factors for survival (all P &lt; 0.05). The incidence of pneumothorax in patients with lesions &lt;1 cm and ≥1cm from the chest wall was 33.3% and 56.7%, respectively, and the differences were statistically significant (P = 0.026).ConclusionL-SABT showed acceptable efficacy in the treatment of unresectable early-stage NSCLC. But the incidence of pneumothorax is high. For patients with T1 stage and lesions &lt;1 cm from the chest wall, it may have better efficacy. Prescription dose greater than 150 Gy may bring better results.

scholarly journals Long-term analysis of bilateral versus unilateral neck dissection in the treatment of early-stage supraglottic laryngeal cancer

2021 ◽  
Vol 9 (3) ◽  
pp. 81-86
Author(s):  
Selin Ünsaler
Keyword(s):  
Overall Survival ◽  
Neck Dissection ◽  
Cancer Patients ◽  
Early Stage ◽  
Survival Rates ◽  
Survival Outcomes ◽  
Tumor Site ◽  
Significant Difference ◽  
Overall Survival Rates

OBJECTIVE: This study aimed to investigate the effect of routine bilateral neck dissection on the survival outcomes of supraglottic laryngeal cancer patients with lateralized tumors and clinically negative necks. METHODS: The data of 234 patients surgically treated for supraglottic squamous cell carcinoma between January 2000 and September 2014 were retrospectively collected. Patients treated previously for head and neck cancer, patients who could not be contacted, and those with missing data were excluded. Of the remaining 187 patients, 124 patients with early-stage primaries (T1-T2) (116 males, 8 females; mean age: 55.5±9.5 years; range, 33 to 82 years) were included. Age and sex of the patients, site of the primary tumor, TNM stage, type of the neck dissection, length of follow-up, and survival rates were evaluated. The tumors were classified into three groups according to their relationship with the median line of the larynx, and the neck dissections were recorded as unilateral or bilateral. Recurrences and survival outcomes were evaluated. RESULTS: There was no statistically significant difference in the recurrences according to tumor site groups (p=0.39). Similarly, there was no statistically significant difference in 10-year overall survival rates in patient groups according to the tumor site (p=0.072). We found no statistically significant difference in 10-year overall survival rates between the patients who underwent unilateral and bilateral neck dissection (p=0.580). CONCLUSION: Long-term survival analysis of 124 patients with supraglottic carcinoma did not show a survival benefit of elective contralateral neck dissection in lateralized supraglottic cancer with contralateral clinically negative neck.

Survival by anatomic site, histologic type, and tumor stage in stomach and esophageal cancer patients from the U.S. SEER Cancer Registry.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 28-28
Author(s):  
L. Wang ◽  
L. Chu ◽  
M. Shing ◽  
W. Dong
Keyword(s):  
Esophageal Cancer ◽  
Cancer Registry ◽  
Early Stage ◽  
Tumor Stage ◽  
Stage I ◽  
Stage Iiib ◽  
Intestinal Type ◽  
Disease Stage ◽  
Histologic Type ◽  
Anatomic Site

28 Background: Data on the association of tumor characteristics and survival for stomach cancer (SC) and esophageal cancer (EC) patients (pts) are limited. The objective of this study was to describe survival in United States. SC and EC pts by anatomic site, histologic type, and tumor stage. Methods: SC and EC pts were identified in the Surveillance, Epidemiology and End Results (SEER) Cancer Registry. SC was classified by anatomic site (cardia and non-cardia/other) and histologic type (intestinal, diffuse, other per Lauren criteria). EC was classified into anatomic site (middle/upper third, abdominal/lower third, overlapping lesions, NOS) and histologic type (adenocarcinoma (AC), squamous cell carcinoma (SQ), other). Frequency distribution and median survival were examined in these subgroups. Results: From 2004-2006, >15,500 SC and > 9,800 EC cases were diagnosed. SC: (29% cardia) and (24% diffuse, 66% intestinal, 10% other). Compared with non-cardia/other pts, cardia pts tended to be male (77% vs 56%), white (88% vs 66%), intestinal type (77% vs 61%) and present with earlier stage disease (stage I-IIIa: 48% vs 42%). With the exception of stage I/II pts, survival was longer in cardia than non-cardia/other pts. The difference was most striking in stage IIIb/IV pts (7 months (mos) cardia vs 4 mos non-cardia/other). Compared to intestinal type, diffuse type tended to be younger (median age: 64 vs 72 yrs), more female (49% vs 34%), and present with more stage IIIb/IV disease (50% vs 39%). No difference in survival by histologic type was observed when accounting for stage. EC: (26% middle/upper, 58% lower, 5% overlapping, 11% NOS) and (57% AC, 34% SQ, 9% other). Among pts with AC histology 78% occurred in the lower third; in SQ most occurred in upper/middle third (56%). Compared to SQ, AC tended to be male (85% vs 63%), white (95% vs 67%), and present with stage IV disease (34% vs 25%). For all stages combined, survival was longer for AC pts (11 mos AC, 9 mos SQ, 4 mos other). This difference was most apparent among early stage (I-III) pts. Conclusions: Survival in SC and EC was associated with staging, anatomic and histologic subtypes. Quantifying this provides insights for the design and interpretation of clinical development programs. [Table: see text]

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