Hypofractionated Radiotherapy in the Treatment of Early Glottic Carcinoma

ABSTRACT Introduction Given the high probability of cure, the aims of treatment are cure, laryngeal preservation and good voice quality while making effective use of available resources. In this study we analyze locoregional control (LRC) and survival following hypofractionated radiotherapy in early stage glottic squamous cell carcinoma treated at Shaukat Khanum Memorial Cancer Hospital and Research Center. Materials and methods Between October 2003 and June 2009, 87 patients with early glottic squamous cell carcinoma were treated with hypofractionated radiotherapy. All patients were included in the study (M: 94%; F:6%). Median age was 60 years (range: 21-81 years). Sixty-six percent of patients were smokers. AJCC stage was T1 in 95% and T2 in 5% of the patients. Radiotherapy dose was 55 Gy in 20 fractions over 4 weeks. All patients were treated on cobalt-60. Median radiotherapy treatment time was 28 days (range: 23-35 days). Results The LRC rate after primary radiotherapy at 5 years was 91% (95% CI: 88-94%). The 5 years overall and disease-specific survival was 86% (95% CI: 81 and 91%) and 97% (CI 95%: 95 and 99%) respectively. Patients with T1a and T1b disease had LRC rates of 95 and 88% (p = 0.32). The LRC rates for patients with and without anterior commissure involvement at 5 years were 80 and 96% (p = 0.02) respectively. Conclusion Hypofractionated radiotherapy 55 Gy in 20 fractions is comparable to conventional fractionation schedules in terms of locoregional control and survival while offering potential for optimizing resources usage.

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Retrospective analysis of Ca cervix postoperative: An institutional study

10.1055/s-0039-1685282 ◽

2016 ◽

Author(s):

Chandra Prakash

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Treatment Time ◽

Residual Disease ◽

Early Stage ◽

Treatment Length ◽

Recommended Treatment ◽

Carcinoma Of Cervix ◽

Well Differentiated

Introduction: Carcinoma of cervix is one of the leading causes of death worldwide and in developing countries like India. Cervical cancer is third most common cancer among women however there is a good chance of curability if diagnosed in early stage. Materials and Methods: We had analysed 78 patient of carcinoma of cervix post op who were registered from 2012 to 2015 at Dr. Ram Manohar Lohia Institute of Medical Sciences. Results: We analysed 78 patients between age of 32-70 years and median age is 50 year. Among all patients squamous cell carcinoma is most common (65 patient), adenocarcinoma were 12 and lieomyosarcoma was 1 patient. Among all patient 12 were of adenocarcinoma, 1 of lieomyosarcoma and 65 patient of squamous cell carcinoma. On examination 55 patients were NAD and 23 were residual. Among squamous cell carcinoma 35 were moderate differentiated, 18 were well differentiated and 12 were of poorly differentiated. On examination 55 patients were NAD rest were having disease. Gap between EBRT and SORBO ranging from 3 to 99 days and median is 27 days and median is 29 days. Treatment length varies from 4 cm to 8 cm and median is 6 cm. Ovoide size ranges from 2.5 cm to 3.5 cm and median is 2.5 cm. Dose per fraction ranges from 5 Gy to 9 Gy and median was 9 Gy. Median fraction of session were 2. Out of 78 patients 2 were developed metastasis and 6 having residual disease. 28 patients were NAD and rest were referral and send back to parent hospital. Conclusion: Due to lack of resources and awareness of disease maximum number of patient presented with advanced stage. The recommended treatment time could not be achieved due to scarcity of cancer centres, treatment time is prolonged. We have not found any relation between treatment length and outcome. We are still investigating to conclude to found out relation among these variables.

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Thyroid cartilage invasion in early-stage squamous cell carcinoma involving the anterior commissure

Head & Neck ◽

10.1002/hed.21950 ◽

2011 ◽

Vol 34 (10) ◽

pp. 1476-1479 ◽

Cited By ~ 16

Author(s):

Dana M. Hartl ◽

Guillaume Landry ◽

Stéphane Hans ◽

Patrick Marandas ◽

Odile Casiraghi ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Anterior Commissure ◽

Thyroid Cartilage ◽

Cartilage Invasion

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

Otolaryngology ◽

10.1177/0194599817728476 ◽

2017 ◽

Vol 158 (2) ◽

pp. 295-302 ◽

Cited By ~ 12

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.

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Quality of Life After Primary TORS vs IMRT for Patients With Early-stage Oropharyngeal Squamous Cell Carcinoma

Case Medical Research ◽

10.31525/ct1-nct04124198 ◽

2019 ◽

Author(s):

Keyword(s):

Quality Of Life ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Oropharyngeal Squamous Cell Carcinoma

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A nomogram to predict lymph node metastasis risk for early esophageal squamous cell carcinoma

BMC Cancer ◽

10.1186/s12885-021-08077-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaofeng Duan ◽

Xiaobin Shang ◽

Jie Yue ◽

Zhao Ma ◽

Chuangui Chen ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Derivation Cohort ◽

Node Metastasis

Abstract Background A nomogram was developed to predict lymph node metastasis (LNM) for patients with early-stage esophageal squamous cell carcinoma (ESCC). Methods We used the clinical data of ESCC patients with pathological T1 stage disease who underwent surgery from January 2011 to June 2018 to develop a nomogram model. Multivariable logistic regression was used to confirm the risk factors for variable selection. The risk of LNM was stratified based on the nomogram model. The nomogram was validated by an independent cohort which included early ESCC patients underwent esophagectomy between July 2018 and December 2019. Results Of the 223 patients, 36 (16.1%) patients had LNM. The following three variables were confirmed as LNM risk factors and were included in the nomogram model: tumor differentiation (odds ratio [OR] = 3.776, 95% confidence interval [CI] 1.515–9.360, p = 0.004), depth of tumor invasion (OR = 3.124, 95% CI 1.146–8.511, p = 0.026), and tumor size (OR = 2.420, 95% CI 1.070–5.473, p = 0.034). The C-index was 0.810 (95% CI 0.742–0.895) in the derivation cohort (223 patients) and 0.830 (95% CI 0.763–0.902) in the validation cohort (80 patients). Conclusions A validated nomogram can predict the risk of LNM via risk stratification. It could be used to assist in the decision-making process to determine which patients should undergo esophagectomy and for which patients with a low risk of LNM, curative endoscopic resection would be sufficient.

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The REASON score: an epigenetic and clinicopathologic score to predict risk of poor survival in patients with early stage oral squamous cell carcinoma

Biomarker Research ◽

10.1186/s40364-021-00292-x ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Chi T. Viet ◽

Gary Yu ◽

Kesava Asam ◽

Carissa M. Thomas ◽

Angela J. Yoon ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Risk Score ◽

Squamous Cell ◽

Early Stage ◽

Genome Wide Association Studies ◽

Gene Methylation ◽

Poor Survival ◽

Risk Of Death

Abstract Background Oral squamous cell carcinoma (OSCC) is a capricious cancer with poor survival rates, even for early-stage patients. There is a pressing need to develop more precise risk assessment methods to appropriately tailor clinical treatment. Genome-wide association studies have not produced a viable biomarker. However, these studies are limited by using heterogeneous cohorts, not focusing on methylation although OSCC is a heavily epigenetically-regulated cancer, and not combining molecular data with clinicopathologic data for risk prediction. In this study we focused on early-stage (I/II) OSCC and created a risk score called the REASON score, which combines clinicopathologic characteristics with a 12-gene methylation signature, to predict the risk of 5-year mortality. Methods We combined data from an internal cohort (n = 515) and The Cancer Genome Atlas (TCGA) cohort (n = 58). We collected clinicopathologic data from both cohorts to derive the non-molecular portion of the REASON score. We then analyzed the TCGA cohort DNA methylation data to derive the molecular portion of the risk score. Results 5-year disease specific survival was 63% for the internal cohort and 86% for the TCGA cohort. The clinicopathologic features with the highest predictive ability among the two the cohorts were age, race, sex, tobacco use, alcohol use, histologic grade, stage, perineural invasion (PNI), lymphovascular invasion (LVI), and margin status. This panel of 10 non-molecular features predicted 5-year mortality risk with a concordance (c)-index = 0.67. Our molecular panel consisted of a 12-gene methylation signature (i.e., HORMAD2, MYLK, GPR133, SOX8, TRPA1, ABCA2, HGFAC, MCPH1, WDR86, CACNA1H, RNF216, CCNJL), which had the most significant differential methylation between patients who survived vs. died by 5 years. All 12 genes have already been linked to survival in other cancers. Of the genes, only SOX8 was previously associated with OSCC; our study was the first to link the remaining 11 genes to OSCC survival. The combined molecular and non-molecular panel formed the REASON score, which predicted risk of death with a c-index = 0.915. Conclusions The REASON score is a promising biomarker to predict risk of mortality in early-stage OSCC patients. Validation of the REASON score in a larger independent cohort is warranted.

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De-Escalation of Therapy for Patients with Early-Stage Squamous Cell Carcinoma of the Anus

Cancers ◽

10.3390/cancers13092099 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2099

Author(s):

Eric Miller ◽

Jose Bazan

Keyword(s):

Squamous Cell Carcinoma ◽

Radiation Therapy ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

Intensity Modulated Radiation Therapy ◽

Late Toxicity ◽

Standard Of Care ◽

The Elderly ◽

Current Standard

The incidence of squamous cell carcinoma of the anus (SCCA) is increasing, particularly in the elderly, with increased mortality in this age group. While the current standard of care for localized SCCA remains chemoradiation (CRT), completion of this treatment can be challenging with risks for severe acute and late toxicity. It remains unclear if full course CRT is required for the management of early-stage SCCA or if de-escalation of treatment is possible without compromising patient outcomes. Alternative therapies include radiation therapy alone or local excision for appropriate patients. Modifying standard CRT may also reduce toxicity including the routine use of intensity-modulated radiation therapy for treatment delivery, modification of treatment volumes, and selection and dosing of concurrent systemic therapy agents. Finally, we provide an overview of currently accruing prospective trials focused on defining the role of de-escalation of therapy in patients with early-stage SCCA.

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