Final results following exclusive chemotherapy for selected patients with squamous cell carcinoma of the laryngopharynx

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6039-6039
Author(s):  
C. Holsinger ◽  
V. Bassot ◽  
D. Brasnu ◽  
O. Laccourreye
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Induction Chemotherapy ◽  
Local Control ◽  
Squamous Cell ◽  
Local Therapy ◽  
Local Control Rate ◽  
Oncologic Outcomes ◽  
Glottic Cancer

6039 Purpose: To determine the long-term oncologic outcomes for patients with squamous cell carcinoma (SCC) of the laryngopharynx treated with exclusive chemotherapy after complete clinical response to induction chemotherapy. Materials and Methods: After platin-based induction chemotherapy, selected patients with a complete clinical and histologic response were treated exclusively with additional chemotherapy and observed closely. The rates of overall survival, disease control, and organ preservation were calculated. Results: Survival at 1- and 5-years was 94.5% and 60.2%, respectively. Main causes of death were metachronous second primaries (27) and intercurrent disease (23) than local recurrence (10), distant metastasis, (9) and nodal recurrence (4). The 1-, 3- and 5- year Kaplan-Meier local control estimates were 73.5%, 53.3%, and 50.3%, respectively. No variable was associated with local recurrence using a multivariate analysis. Salvage treatment resulted in an observed final 85.6% local control rate and varied from 96% in patients with glottic cancer to 71% in patients with tumor originating from other locations. Overall, this treatment approach was well-tolerated: 30 patients (20%) experienced grade 3 toxicity; two patients (1.4%) had grade 4 toxicity events. Overall, chemotherapy allowed for successful modulation of local therapy in 66% of patients (96/146). Conclusions: For selected patients, exclusive chemotherapy does not significantly impact survival and maintains function in a majority of patients. Most remarkable, platin-based chemotherapy permitted us to modulate and to diminish the extent of local therapy. Future work should be directed to identify markers of response and resistance to identify which patients are best suited for this approach. No significant financial relationships to disclose.

Cisplatin-fluorouracil exclusive chemotherapy for T1-T3N0 glottic squamous cell carcinoma complete clinical responders: five-year results.

1996 ◽  
Vol 14 (8) ◽  
pp. 2331-2336 ◽  
Author(s):  
O Laccourreye ◽  
D Brasnu ◽  
V Bassot ◽  
M Ménard ◽  
D Khayat ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Local Control ◽  
Squamous Cell ◽  
Distant Metastasis ◽  
Primary Tumor ◽  
Second Primary ◽  
Nodal Recurrence ◽  
Second Primary Tumor

PURPOSE To evaluate cisplatin-fluorouracil exclusive chemotherapy (EC) for T1-T3N0 glottic squamous cell carcinoma complete clinical responders (CCR) after cisplatin-fluorouracil induction chemotherapy (IC). PATIENTS AND METHODS A retrospective analysis was performed of 58 patients with T1-T3N0 glottic squamous cell carcinoma CCR after IC consecutively managed at our department between 1985 and 1992. Twenty-one CCR were managed with EC. Thirty-seven CCR were managed with IC and a conventional laryngeal-preservation modality. Analyses of survival, local control, nodal recurrence, distant metastasis, and metachronous second primary tumor were performed using the Kaplan-Meier actuarial life-table method. In CCR managed with EC, the independent factors of age, tumor classification, exact tumor location, true vocal cord motion, arytenoid cartilage motion, total dosage of drugs delivered, and number of courses received were tested for potential correlation with survival, local recurrence, nodal recurence, and distant metastasis. RESULTS The 5-year survival, local control, nodal recurrence, distant metastasis, and metachronous second primary tumor rates in CCR managed with EC were 95.2%, 70.7%, 0%, 0%, and 14.3%, respectively. The 5-year rates of survival, local control, nodal recurrence, distant metastasis, and metachronous second primary tumor in CCR managed with IC and a conventional laryngeal-preservation modality were 86.1%, 97%, 2.7%, 6%, and 14.5%, respectively. Local recurrence was statistically more likely in CCR managed with EC (P = .002). Local recurrence in CCR managed with EC was always salvaged with partial laryngectomy or radiation therapy, which resulted in an overall 100% local control and laryngeal-preservation rate within this group. In CCR managed with EC, none of the variables analyzed was statistically related to survival, local recurrence, nodal recurrence, or distant metastasis. CONCLUSION The present retrospective studies demonstrated that within T1-T3N0 glottic squamous cell carcinoma CCR, there is clearly a significant subset of patients with chemocurable tumors who achieved both perfect preservation of structure-supporting voice and long-term survival after EC. Careful monthly follow-up evaluation allowed for timely successful salvage of local recurrence after EC without the need for total laryngectomy. Such management did not appear to increase the risk for subsequent nodal failure, subsequent distant metastasis, or reduced survival.

scholarly journals Induction Chemotherapy for Orbit Preservation in Sinonasal Squamous Cell Carcinoma

2021 ◽  
Vol 82 (03) ◽  
pp. e36-e37
Author(s):  
Gabriela Lilly ◽  
Mathew Geltzeiler
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Induction Chemotherapy ◽  
Squamous Cell ◽  
Gold Standard ◽  
Standard Treatment ◽  
Oncologic Outcomes ◽  
Significant Morbidity ◽  
Orbital Invasion

AbstractSinonasal squamous cell carcinoma (SNSCC) is a rare and aggressive malignancy which often presents at an advanced stage. The gold-standard treatment includes negative-margin surgical resection plus adjuvant therapy. In cases of orbital invasion, surgery requires orbital exenteration which can carry significant morbidity and result in decreased quality of life. In selected patients, induction chemotherapy (IC) can allow for orbit preservation without compromising oncologic outcomes. The available literature will be briefly discussed.

Surgical Treatment for Early Stage Glottic Carcinoma with Involvement of the Anterior Commissure

2017 ◽  
Vol 158 (2) ◽  
pp. 295-302 ◽  
Author(s):  
Philipp Wolber ◽  
David Schwarz ◽  
Thoralf Stange ◽  
Magdalene Ortmann ◽  
Matthias Balk ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Recurrence Rate ◽  
Squamous Cell ◽  
Early Stage ◽  
Anterior Commissure ◽  
Glottic Cancer ◽  
Recurrence Rates ◽  
Significant Difference

Objective Assessment of the value of transoral laser microsurgery (TLM) compared with open surgery (OS) for early stage squamous cell carcinoma of the glottic larynx with special regard to involvement of the anterior commissure (AC). Study Design Case series with chart review. Setting Tertiary care otolaryngology clinic. Subjects and Methods Review of clinicopathological data of all patients with previously untreated T1a, T1b, and T2 glottic squamous cell carcinoma of the larynx who were consecutively enrolled over a 10-year period (January 1, 1992, to December 31, 2002). Results Local recurrence rate was 20.4% (10 of 49) for TLM and 10.7% (3 of 28) for OS. Comparison of the TLM and OS groups regarding local recurrence rates revealed a significant difference only for tumors invading the AC ( P = .046). Within the TLM group, tumors with involvement of the AC showed a significantly higher recurrence rate (38.1%; 8 of 21) compared with tumors without involvement of the AC (7.1%; 2 of 28; P = .008). In the OS group, involvement of the AC revealed no significant difference ( P = .45). The overall survival in both groups was comparable in both groups (TLM, 93.9%; OS, 89.3%; P = .47). Conclusion TLM and OS are equally effective surgical treatments for early stage glottic cancer without involvement of the AC, with selection of treatment based on pretreatment endoscopy. However, TLM is associated with less morbidity. In case of invasion of the AC, OS yields lower recurrence rates.

When Does Skin Excision Allow the Achievement of an Adequate Local Control Rate in Patients with Squamous Cell Carcinoma Involving the Buccal Mucosa?

2008 ◽  
Vol 15 (8) ◽  
pp. 2187-2194 ◽  
Author(s):  
Chun-Ta Liao ◽  
Shiang-Fu Huang ◽  
I-How Chen ◽  
Joseph Tung-Chieh Chang ◽  
Hung-Ming Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Local Control ◽  
Squamous Cell ◽  
Buccal Mucosa ◽  
Local Control Rate ◽  
Skin Excision

scholarly journals Induction Chemotherapy and Cetuximab for Locally Advanced Squamous Cell Carcinoma of the Head and Neck: Results From a Phase II Prospective Trial

2010 ◽  
Vol 28 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Merrill S. Kies ◽  
Floyd Christopher Holsinger ◽  
J. Jack Lee ◽  
William N. William ◽  
Bonnie S. Glisson ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Phase Ii ◽  
Squamous Cell ◽  
Systemic Disease ◽  
Locally Advanced ◽  
Prospective Trial ◽  
Local Therapy

PurposeTo determine the potential efficacy of combining cetuximab with chemotherapy in patients with advanced nodal disease, we conducted a phase II trial with induction chemotherapy (ICT) consisting of six weekly cycles of paclitaxel 135 mg/m2and carboplatin (area under the curve = 2) with cetuximab 400 mg/m2in week 1 and then 250 mg/m2(PCC).Patients and MethodsForty-seven previously untreated patients (41 with oropharynx primaries; 33 men, 14 women; median age, 53 years; performance status of 0 or 1) with squamous cell carcinoma of the head and neck (SCCHN; T1-4, N2b/c/3) were treated and evaluated for clinical and radiographic response. After ICT, patients underwent risk-based local therapy, which consisted of either radiation, concomitant chemoradiotherapy, or surgery, based on tumor stage and site at diagnosis.ResultsAfter induction PCC, nine patients (19%) achieved a complete response, and 36 patients (77%) achieved a partial response. The most common grade 3 or 4 toxicity was skin rash (45%), followed by neutropenia (21%) without fever. At a median follow-up time of 33 months, locoregional or systemic disease progression was observed in six patients. The 3-year progression-free survival (PFS) and overall survival (OS) rates were 87% (95% CI, 78% to 97%) and 91% (95% CI, 84% to 99%), respectively. Human papillomavirus (HPV) 16, found in 12 (46%) of 26 biopsies, was associated with improved PFS (P = .012) and OS (P = .046).ConclusionICT with weekly PCC followed by risk-based local therapy seems to be feasible, effective, and well tolerated. PFS is promising, and this sequential treatment strategy should be further investigated. Patients with HPV-positive tumors have an excellent prognosis.

scholarly journals Matched-Pair Analysis of Survival in the Patients with Advanced Laryngeal and Hypopharyngeal Squamous Cell Carcinoma Treated with Induction Chemotherapy Plus Chemo-Radiation or Total Laryngectomy

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1735
Author(s):  
Patricia García-Cabo ◽  
Fernando López ◽  
Mario Sánchez-Canteli ◽  
Laura Fernández-Vañes ◽  
César Álvarez-Marcos ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Induction Chemotherapy ◽  
Squamous Cell ◽  
Organ Preservation ◽  
Matched Pair ◽  
Primary Tumors ◽  
Free Survival ◽  
Tumor Node Metastasis Stage ◽  
Significant Difference

Background: We performed a comparative analysis between an organ-preservation protocol and surgery followed by radiotherapy in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx; Methods: 60 previously untreated patients who were treated with induction chemotherapy followed by chemoradiotherapy in responders were compared with a control group of 60 patients treated with up-front surgery. Both groups were statistically comparable, according to the subsite, TNM (tumor-node-metastasis) stage, age, and sex; Results: Mean age was 58 years and 92% were male. No significant statistical difference was observed for overall survival (OS) (HR 0.75; 95% CI 0.48–1,18; P = 0.22) and disease-specific survival (DSS) (HR 0.98; 95% CI 0.52–1.83, P = 0.96). Also, there was no significant difference for recurrence-free survival (HR 0.931; 95% CI 0.57–1.71; P = 0.81), metastases-free survival (HR 2.23; 95% CI 0.67–7.41; P = 0.19), and the appearance of second primary tumors (HR 1.22; 95% CI 0.51–2.88; P = 0.64); Conclusions: The results of the organ-preservation approach did not appear inferior to those of surgery plus (chemo)radiotherapy for patients with T3/T4a larynx and T2–T4a hypopharynx cancer with respect to OS and DSS, locoregional control and metastases-free survival.

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