Chemoradiotherapy for high-risk stage II laryngeal cancer
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ORIGINAL ARTICLE
Chemoradiotherapy for high‑risk stage II laryngeal cancer Satoshi Hamauchi1 · Tomoya Yokota1 · Yusuke Onozawa2 · Hirofumi Ogawa3 · Tsuyoshi Onoe3 · Tomoyuki Kamijo4 · Yoshiyuki Iida4 · Tetsuro Onitsuka4 · Hirofumi Yasui1 Received: 8 March 2020 / Accepted: 7 May 2020 © Japan Society of Clinical Oncology 2020
Abstract Background Definitive radiotherapy (RT) for stage II laryngeal cancer is known to be less effective for locoregional control and survival (LRCS) in patients with high-risk factors (e.g., subglottic extension, impaired cord mobility, or bulky tumor size) than in low-risk patients. The purpose of this study was to evaluate the safety and efficacy of chemoradiotherapy (CRT) for stage II laryngeal cancer patients with high-risk factors Methods Sixty-five consecutive patients with stage II laryngeal cancer who received radiotherapy (RT) alone or CRT were retrospectively analyzed. The patients were classified into three groups: RT, low risk (RT-low, n = 26); RT, high risk (RThigh, n = 25); and CRT, high risk (CRT-high, n = 14). Results The glottis was the most common primary tumor site in all groups. Most patients in the CRT-high group received platinum-based CRT. The 5-year locoregional control and survival (LRCS) rates were 88.3, 44.2, and 85.7% in the RT-low, RT-high, and CRT-high groups, respectively. In multivariate analysis, high-risk disease and CRT were significantly associated with 5-year LRCS rates. Conclusion CRT may provide better locoregional control than RT alone in high-risk stage II laryngeal cancer. Keywords Chemoradiotherapy · Radiotherapy · Stage II laryngeal cancer · Glottic cancer · High-risk factors
Introduction Definitive radiotherapy (RT) is the standard treatment for patients with stage II laryngeal cancer. The intent of RT is to preserve the larynx, and the 5-year locoregional control and survival (LRCS) rate is reported to be about 80% [1]. However, the 5-year LRCS rate in patients with high-risk stage II laryngeal cancer, including those with subglottic extension, impaired cord mobility, anterior commissure extension, or bulky tumor, has been reported to be about 40–73% [2–8]. * Tomoya Yokota [email protected] 1
Despite the unfavorable outcomes in high-risk patients, no prospective trials have been conducted in this population. There have been several retrospective studies on chemoradiotherapy (CRT) for stage II laryngeal cancer, in which the 5-year LRCS rates were 65–81% with no statistically significant difference in the LRCS rate between RT alone and CRT [9–13]. However, in those studies, patients with stage II laryngeal cancer received CRT regardless of their risk status. Therefore, the efficacy of CRT in high-risk stage II laryngeal cancer is still unknown. The aim of this study was to examine the safety and efficacy of CRT in patients with stage II laryngeal cancer and subglottic extension, impaired cord mobility, or bulky tumor size.
Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto‑gun, Shizuo
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