Organ Preservation With Concurrent Chemoradiation for Advanced Laryngeal Cancer: Are We Succeeding?

Journal Article · Mon Feb 01 04:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.01.058· OSTI ID:21372052

Lambert, Louise ^[1]; Fortin, Bernard ^[1]; Soulieres, Denis ^[2]; Guertin, Louis ^[3]; Coulombe, Genevieve ^[1]; Charpentier, Danielle ^[2]; Tabet, Jean-Claude ^[3]; Belair, Manon ^[4]; Khaouam, Nader ^[5]; Nguyen-Tan, Phuc Felix ^[1]

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1. Department of Radiation Oncology, CHUM - Hopital Notre-Dame, Montreal, Quebec (Canada)
2. Department of Hematology and Oncology, CHUM - Hopital Notre-Dame, Montreal, Quebec (Canada)
3. Department of Otolaryngology, CHUM - Hopital Notre-Dame, Montreal, Quebec (Canada)
4. Department of Radiology, CHUM - Hopital Notre-Dame, Montreal, Quebec (Canada)
5. Department of Radiation Oncology, Hopital Maisonneuve-Rosemont, Montreal, Quebec (Canada)

Purpose: To determine the rates of organ preservation and function in patients with advanced laryngeal and hypopharyngeal carcinomas treated with concurrent chemoradiotherapy (CRT). Methods and Materials: Between April 1999 and September 2005, 82 patients with advanced laryngeal (67%) and hypopharyngeal carcinomas (33%) underwent conventional radiotherapy and concurrent platinum-based chemotherapy with curative intent. Sixty-two patients were male (75.6%). The median age was 59 years. Eighteen patients (22%) were in Stage III and 64 (78%) were in Stage IV. The median radiation dose was 70 Gy. The median potential follow-up was 3.9 years. Results: Overall survival and disease-free survival were respectively 63% and 73% at 3 years. Complete response rate from CRT was 75%. Nineteen patients (23%) experienced significant long-term toxicity after CRT: 6 (7.3%) required a percutaneous endoscopic gastrostomy, 5 (6%) had persistent Grade 2 or 3 dysphagia, 2 (2.4%) had pharyngoesophageal stenosis requiring multiple dilations, 2 (2.4%) had chronic lung aspiration, and 7 (8.5%) required a permanent tracheostomy. Four patients (4.9%) underwent laryngectomy without pathologic evidence of disease. At last follow-up, 5 (6%) patients were still dependent on a gastrostomy. Overall, 42 patients (52%) were alive, in complete response, with a functional larynx and no other major complications. Conclusions: In our institution, CRT for advanced hypopharyngeal and laryngeal carcinoma has provided good overall survival and locoregional control in the majority of patients, but a significant proportion did not benefit from this approach because of either locoregional failure or late complications. Better organ preservation approaches are necessary to improve locoregional control and to reduce long-term toxicities.

• OSTI ID: 21372052
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARCINOMAS
CHEMOTHERAPY
COMBINED THERAPY
DIGESTIVE SYSTEM
DISEASES
LARYNX
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PHARYNX
PRESERVATION
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
THERAPY