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Title: Truths and Myths About Radiotherapy for Verrucous Carcinoma of Larynx

Abstract

Purpose: The role of primary radiotherapy (RT) for laryngeal verrucous carcinoma (LVC) is controversial because of concerns about anaplastic transformation, an increased incidence of metastases, and poorer local control after RT. To address these concerns, we report our experience. Methods and Materials: All patients with pathologically diagnosed LVC treated with primary RT at our institution between 1961 and 2004 were reviewed. The local control, overall survival, and disease-specific survival rate were established. The outcome after salvage treatment and the incidence of metastases and anaplastic transformation were determined. Results: Of 62 LVC patients with a minimal follow-up of 2 years, 20 local and 1 nodal recurrence were identified. Salvage surgery was undertaken in 18 of the 21 patients, and disease control was achieved in 17; the eighteenth patient died of a complication after surgery. Ultimate laryngeal preservation was achieved in 50 patients (81%), including 42 after initial RT and an additional 8 after salvage surgery. Distant failure and anaplastic transformation were not observed. Second cancers after RT were identified in 4 patients, only 1 of which was a head-and-neck cancer detected 11 years later. Of the 39 deceased patients, only 3 died of LVC. The local control, overall survival, and disease-specificmore » survival rate at 5 years was 66% (95% confidence interval, 52-77%), 87% (95% confidence interval, 75-93%), and 97% (95% confidence interval, 87-99%), respectively. Conclusion: The results of our study have shown that the initial control of LVC with RT is less reliable compared with reports from surgical series; however, local recurrence was almost always salvaged successfully, resulting in disease-specific survival rates equivalent to those of surgical series. Neither anaplastic transformation nor unusual metastasis development was observed in this series.« less

Authors:
 [1];  [2];  [3];  [1]; ;  [1]; ; ; ;  [1];  [1]
  1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada)
  2. Department of Biostatistics, Princess Margaret Hospital, Toronto, ON (Canada)
  3. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON (Canada)
Publication Date:
OSTI Identifier:
21172672
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 73; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2008.05.021; PII: S0360-3016(08)00846-8; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; FAILURES; HEAD; LARYNX; METASTASES; NECK; PATIENTS; RADIOTHERAPY; SURGERY

Citation Formats

Shaohui, Huang, Department of Radiation Oncology, University of Toronto, Toronto, ON, Lockwood, Gina, Irish, Jonathan, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Ringash, Jolie, Department of Radiation Oncology, University of Toronto, Toronto, ON, Cummings, Bernard, Waldron, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Kim, John, Dawson, Laura A, Bayley, Andrew, Hope, Andrew, Department of Radiation Oncology, University of Toronto, Toronto, ON, O'Sullivan, Brian, Department of Radiation Oncology, University of Toronto, Toronto, ON, and Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON. Truths and Myths About Radiotherapy for Verrucous Carcinoma of Larynx. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.05.021.
Shaohui, Huang, Department of Radiation Oncology, University of Toronto, Toronto, ON, Lockwood, Gina, Irish, Jonathan, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Ringash, Jolie, Department of Radiation Oncology, University of Toronto, Toronto, ON, Cummings, Bernard, Waldron, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Kim, John, Dawson, Laura A, Bayley, Andrew, Hope, Andrew, Department of Radiation Oncology, University of Toronto, Toronto, ON, O'Sullivan, Brian, Department of Radiation Oncology, University of Toronto, Toronto, ON, & Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON. Truths and Myths About Radiotherapy for Verrucous Carcinoma of Larynx. United States. https://doi.org/10.1016/j.ijrobp.2008.05.021
Shaohui, Huang, Department of Radiation Oncology, University of Toronto, Toronto, ON, Lockwood, Gina, Irish, Jonathan, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Ringash, Jolie, Department of Radiation Oncology, University of Toronto, Toronto, ON, Cummings, Bernard, Waldron, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Kim, John, Dawson, Laura A, Bayley, Andrew, Hope, Andrew, Department of Radiation Oncology, University of Toronto, Toronto, ON, O'Sullivan, Brian, Department of Radiation Oncology, University of Toronto, Toronto, ON, and Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON. 2009. "Truths and Myths About Radiotherapy for Verrucous Carcinoma of Larynx". United States. https://doi.org/10.1016/j.ijrobp.2008.05.021.
@article{osti_21172672,
title = {Truths and Myths About Radiotherapy for Verrucous Carcinoma of Larynx},
author = {Shaohui, Huang and Department of Radiation Oncology, University of Toronto, Toronto, ON and Lockwood, Gina and Irish, Jonathan and Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON and Ringash, Jolie and Department of Radiation Oncology, University of Toronto, Toronto, ON and Cummings, Bernard and Waldron, John and Department of Radiation Oncology, University of Toronto, Toronto, ON and Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON and Kim, John and Dawson, Laura A and Bayley, Andrew and Hope, Andrew and Department of Radiation Oncology, University of Toronto, Toronto, ON and O'Sullivan, Brian and Department of Radiation Oncology, University of Toronto, Toronto, ON and Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON},
abstractNote = {Purpose: The role of primary radiotherapy (RT) for laryngeal verrucous carcinoma (LVC) is controversial because of concerns about anaplastic transformation, an increased incidence of metastases, and poorer local control after RT. To address these concerns, we report our experience. Methods and Materials: All patients with pathologically diagnosed LVC treated with primary RT at our institution between 1961 and 2004 were reviewed. The local control, overall survival, and disease-specific survival rate were established. The outcome after salvage treatment and the incidence of metastases and anaplastic transformation were determined. Results: Of 62 LVC patients with a minimal follow-up of 2 years, 20 local and 1 nodal recurrence were identified. Salvage surgery was undertaken in 18 of the 21 patients, and disease control was achieved in 17; the eighteenth patient died of a complication after surgery. Ultimate laryngeal preservation was achieved in 50 patients (81%), including 42 after initial RT and an additional 8 after salvage surgery. Distant failure and anaplastic transformation were not observed. Second cancers after RT were identified in 4 patients, only 1 of which was a head-and-neck cancer detected 11 years later. Of the 39 deceased patients, only 3 died of LVC. The local control, overall survival, and disease-specific survival rate at 5 years was 66% (95% confidence interval, 52-77%), 87% (95% confidence interval, 75-93%), and 97% (95% confidence interval, 87-99%), respectively. Conclusion: The results of our study have shown that the initial control of LVC with RT is less reliable compared with reports from surgical series; however, local recurrence was almost always salvaged successfully, resulting in disease-specific survival rates equivalent to those of surgical series. Neither anaplastic transformation nor unusual metastasis development was observed in this series.},
doi = {10.1016/j.ijrobp.2008.05.021},
url = {https://www.osti.gov/biblio/21172672}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 73,
place = {United States},
year = {Sun Mar 15 00:00:00 EDT 2009},
month = {Sun Mar 15 00:00:00 EDT 2009}
}