Clinical Outcome of Definitive Radiotherapy and/or Surgery in T1-2N0M0 Glottic Squamous Cell Carcinoma: A Single Institution Retrospective Report — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Clinical Outcome of Definitive Radiotherapy and/or Surgery in T1-2N0M0 Glottic Squamous Cell Carcinoma: A Single Institution Retrospective Report
Clinical Oncology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
,
Ear, Nose, Throat ENT Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
,
Ear, Nose, Throat ENT Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
Background : The current treatment options of early glottic carcinoma are radiotherapy; trans laser microsurgery, and open surgery. However, the best treatment is still controversial due to lack of randomized controlled trials. We aimed to evaluate the treatment results and the prognostic factors of local control of early glottic squamous cell carcinoma patients (GSCC) T1-2N0M0 treated at our institution. Material and Methods : We retrospectively studied the charts of 52 patients with early GSCC T1-T2N0M0 from 2010-2015 at the Clinical Oncology Department, Ain-Shams University. 24 patients had T1 and 28 had T2 early glottic carcinoma. The overall survival OS, local control rate, and laryngeal preservation rate were evaluated. Kaplan-Meier method, Cox proportional hazards model were used to analyze the data. Results : Median duration of follow-up was 13 months . Thirty-eight patients received radiation treatment alone (73.1%), 7.7% of the patients underwent surgery alone, and 19.2% of the patients had surgery combined with radiotherapy. Local recurrence after radiation failure developed in 6/52 patients, all had T2 disease and were salvaged by total laryngectomy. The ultimate local control rate was 88.5%, and the ultimate laryngeal preservation rate was 77.2% (40/52 patients). The median OS of the 52 patients was 13 months (range 2 - 46 months). Univariate analysis of factors associated with poor local control showed that age > 60 years was the only significant factor ( P = 0.048). Conclusion : Radiotherapy achieves high local control and laryngeal preservation rates for patients with early glottic carcinoma, and is associated with a low rate of severe complications compared to surgery. Salvage surgery is feasible after radiotherapy failure.
Lin, J.R. and Prisman, E. (2014) Transoral Laser Microsurgery for Early Glottic Carcinoma. Surgery Current Research, 4, 5.
Ahn, S.H., Hong, H.J., Kwon, S.Y., Kwon, K.H., Roh, J.L., Ryu, J., et al. (2017) Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery. Clinical and Experimental Otorhinolaryngology, 10, 1-43. https://doi.org/10.21053/ceo.2016.01389
Coughlin, A.M. (2016) Glottic Cancer. Head and Neck Surgery, University of Nebraska Medical Center. Medscape.
Myers, E.N., Suen, J.Y., Myers, J.N. and Hanna, E. (2003) Cancer of the Head and Neck. 4th Edition, Saunders, Philadelphia, PA.
Peng, Z., Li, Y., Jin, L., Tao, X., Cai, X., Feng, J., et al. (2016) Retrospective Analysis of Therapeutic Effect and Prognostic Factors on Early Glottic Carcinoma. Photodiagnosis and Photodynamic Therapy, 15, 167-171. https://doi.org/10.1016/j.pdpdt.2016.06.008
Mendenhall, W.M., Amdur, R.J., Morris, C.G. and Hinerman, R.W. (2001) T1-T2N0 Squamous Cell Carcinoma of the Glottic Larynx Treated with Radiation Therapy. Journal of Clinical Oncology, 19, 4029-4036. https://doi.org/10.1200/JCO.2001.19.20.4029
Hakeem, A.H., Hakeem, I.H. and Wani, F.J. (2015) Treatment for Early Glottic Carcinoma. Journal of Otolaryngology and Reconstructive Surgery, 1, 102. https://doi.org/10.19104/jors.2015.102
Pfister, D.G., Laurie, S.A., Weinstein, G.S., Mendenhall, W.M., Adelstein, D.J., et al. (2006) American Society of Clinical Oncology Clinical Practice Guidelines for the Use of Larynx Preservation Strategies in the Treatment of Laryngeal Cancer. Journal of Clinical Oncology, 24, 3693-3704. https://doi.org/10.1200/JCO.2006.07.4559
Groome, P.A., O’Sullivan, B., Mackillop, W.J., Jackson, L.D., Schulze, K., Irish, J.C., et al. (2006) Compromised Local Control Due to Treatment Interruptions and Late Treatment Breaks in Early Glottic Cancer: Population-Based Outcomes Study Supporting Need for Intensified Treatment Schedules. International Journal of Radiation Oncology Biology Physics, 64, 1002-1012. https://doi.org/10.1016/j.ijrobp.2005.10.010
Chera, B.S., Amdur, R.J., Morris, C.G., Kirwan, J.M. and Mendenhall, W.M. (2010) T1N0 to T2N0 Squamous Cell Carcinoma of the Glottic Larynx Treated with Definitive Radiotherapy. International Journal of Radiation Oncology Biology Physics, 78, 461-466. https://doi.org/10.1016/j.ijrobp.2009.08.066
Warner, L., Chudasama, J., Kelly, C.G., Loughran, S., McKenzie, K., Wight, R., et al. (2014) Radiotherapy versus Open Surgery versus Endolaryngeal Surgery (with or without Laser) for Early Laryngeal Squamous Cell Cancer. Cochrane Database of Systematic Reviews, Issue 12, Art. No.: CD002027. https://doi.org/10.1002/14651858.CD002027.pub2
Trotti 3rd, A., Zhang, Q., Bentzen, S.M., Emami, B., Hammond, M.E., Jones, E., et al. (2006) Randomized Trial of Hyperfractionation versus Conventional Fractionation in T2 Squamous Cell Carcinoma of the Vocal Cord (RTOG 9512). International Journal of Radiation Oncology Biology Physics, 66, S15. https://doi.org/10.1016/j.ijrobp.2006.07.1339
Williams, M.V., James, N.D., Summers, E.T., Barrett, A. and Ash, D.V., Audit Sub-Committee, Faculty of Clinical Oncology, Royal College of Radiologists (2006) National Survey of Radiotherapy Fractionation Practice in 2003. Clinical Oncology (R Coll Radiology), 18, 3-14. https://doi.org/10.1016/j.clon.2005.10.002
Yamazaki, H., Nishiyama, K., Tanaka, E., Koizumi, M. and Chatani, M. (2006) Radiotherapy for Early Glottic Carcinoma (T1N0M0): Results of Prospective Randomized Study of Radiation Fraction Size and Overall Treatment Time. International Journal of Radiation Oncology Biology Physics, 64, 77-82. https://doi.org/10.1016/j.ijrobp.2005.06.014
Remacle, F., Nest, M. and Levine, R.D. (2007) Laser Steered Ultrafast Quantum Dynamics of Electrons in LiH. Physical Review Letters, 99, Article ID: 183902. https://doi.org/10.1103/PhysRevLett.99.183902
Higgins, K.M., Shah, M.D., Ogaick, M.J. and Enepekides, D. (2009) Treatment of Early-Stage Glottic Cancer: Meta-Analysis Comparison of Laser Excision versus Radiotherapy. Journal of Otolaryngology—Head & Neck Surgery, 38, 603-612.
National Institute for Clinical Excellence (2016) Cancer of the Upper Aerodigestive Tract: Assessment and Management in People Aged 16 and over; NICE Guidelines [NG36]. http://www.nice.org.uk/NG36
Edge, S.B., Byrd, D.R., Compton, C.C., Fritz, A.G., Greene, F.L. and Trotti, A. (2010) AJCC Cancer Staging Manual. Springer, New York, Vol. 7, 87-96.
Jones, D.A., Mendenhall, C.M., Kirwan, J., Morris, C.G., Donnan, A., Holwerda, et al. (2010) Radiation Therapy for Management of t1-t2 Glottic Cancer at a Private Practice. American Journal of Clinical Oncology, 33, 587-590. https://doi.org/10.1097/COC.0b013e3181beaab0
Remmelts, A.J., Hoebers, F.J., Klop, W.M., Balm, A.J., Hamming-Vrieze, O. and van den Brekel, M.W. (2013) Evaluation of Laser Surgery and Radiotherapy as Treatment Modalities in Early Stage Laryngeal Carcinoma: Tumor Outcome and Quality of Voice. European Archives of Oto-Rhino-Laryngology, 270, 2079-2087. https://doi.org/10.1007/s00405-013-2460-x
Cuny, F., Gery, B., Florescu, C., Clarisse, B., Blanchard, D., Rame, J.P., et al. (2013) Exclusive Radiotherapy for Stage T1-T2N0M0 Laryngeal Cancer: Retrospective Study of 59 Patients at CFB and CHU de Caen. European Annals of Otorhinolaryngology, Head and Neck Diseases, 130, 251-256. https://doi.org/10.1016/j.anorl.2012.04.013
Bradley, P.J., Mackenzie, K., Wight, R., Pracy, P., Paleri, V. and ENT-UK Head & Neck Group (2009) Consensus Statement on Management in the UK: Transoral Laser Assisted Microsurgical Resection of Early Glottic Cancer. Clinical Otolaryngology, 34, 367-373. https://doi.org/10.1111/j.1749-4486.2009.01944.x
Higgins, K.M. (2011) What Treatment for Early-Stage Glottic Carcinoma among Adult Patients: CO2 Endolaryngeal Laser Excision versus Standard Fractionated External Beam Radiation Is Superior in Terms of Cost Utility? Laryngoscope, 121, 116-134. https://doi.org/10.1002/lary.21226
Mendenhall, W.M., Takes, R.P., Shah, J.P., Bradely, P.J., Beitler, J.J., Strojan, P., et al. (2015) Current Treatment of T1N0 Squamous Cell Carcinoma of the Glottic Larynx. European Archives of Oto-Rhino-Laryngology, 272, 1821-1824. https://doi.org/10.1007/s00405-014-3388-5
Thomas, L., Drinnan, M., Natesh, B., Mehanna, H., Jones, T. and Paleri, V. (2012) Open Conservation Partial Laryngectomy for Laryngeal Cancer: A Systematic Review of English Language Literature. Cancer Treatment Reviews, 38, 203-211. https://doi.org/10.1016/j.ctrv.2011.05.010
Dinapoli, N., Parrilla, C., Galli, J., Autorino, R., Micciche, F., Bussu, F., et al. (2010) Multidisciplinary Approach in the Treatment of T1 Glottic Cancer. The Role of Patient Preference in a Homogenous Patient Population. Strahlentherapie und Onkologie, 186, 607-613. https://doi.org/10.1007/s00066-010-2142-1
Emris, E., Teo, M., Dyker, K.E., Fosker, C., Sen, M. and Prestwich, R.J. (2015) Definitive Hypofractionated Radiotherapy for Early Glottic Carcinoma: Experience of 55Gy in 20 Fractions. Radiation Oncology, 10, 203. https://doi.org/10.1186/s13014-015-0505-6
Mendenhall, W.M., Riggs, C.E., Vaysberg, M., Amdur, R.J. and Werning, J.W. (2010) Altered Fractionation and Adjuvant Chemotherapy for Head and Neck Squamous Cell Carcinoma. Head Neck, 32, 939-945. https://doi.org/10.1002/hed.21261
Harada, A., Sasaki, R., Miyawaki, D., Yoshida, K., Nishimura, H., Ejima, Y., et al. (2015) Treatment Outcomes of the Patients with Early Glottic Cancer Treated with Initial Radiotherapy and Salvaged by Conservative. Japanese Journal of Clinical Oncology, 45, 248-255. https://doi.org/10.1093/jjco/hyu203
Mendenhall, W.M., Parsons, J.T., Millon, R.R. and Fletcher, G.H. (1988) T1-T2 Squamous Cell Carcinoma of the Glottis Larynx Treated with Radiation Therapy: Relationship of Dose Fractionation Factors to Local Control and Complications. International Journal of Radiation Oncology, Biology, Physics, 15, 1267-1273. https://doi.org/10.1016/0360-3016(88)90220-9
Khan, M.K., Koyfman, S.A., Hunter, G.K., Reddy, C.A. and Saxton, J.P. (2012) Definitive Radiotherapy for Early (T1-T2) Glottic Squamous Cell Carcinoma: A 20 Year Cleveland Clinic Experience. Radiation Oncology, 7, 193. https://doi.org/10.1186/1748-717X-7-193
Al-Mamgani, A., van Rooij, P.H., Woutersen, D.P., Mehilal, R., Tans, L., Monserez, D., et al. (2013) Radiotherapy for T1-2N0 Glottic Cancer: A Multivariate Analysis of Predictive Factors for the Long-Term Outcome in 1050 Patients and a Prospective Assessment of Quality of Life and Voice Handicap Index in a Subset of 233 Patients. Clinical Otolaryngology, 38, 306-312. https://doi.org/10.1111/coa.12139
Burke, L.S., Greven, K.M., McGuirt, W.T., Case, D., Hoen, H.M. and Raben, M. (1997) Definitive Radiotherapy for Early Glottic Carcinoma: Prognostic Factors and Implications for Treatment. International Journal of Radiation Oncology, Biology, Physics, 38, 37-42. https://doi.org/10.1016/S0360-3016(96)00613-X
Spector, J.G., Sessions, D.G., Chao, K.S., Hanson, J.M., Simpson, J.R. and Perez, C.A. (1999) Management of Stage II (T2N0M0) Glottic Carcinoma by Radiotherapy and Conservation Surgery. Head Neck, 21, 116-123. https://doi.org/10.1002/(SICI)1097-0347(199903)21:2 3.0.CO;2-8
Cellai, E., Frata, P., Magrini, S.M., Paiar, F., Barca, R., Fondelli, R., et al. (2005) Radical Radiotherapy for Early Glottic Cancer: Results in a Series of 1087 Patients from Two Italian Radiation Oncology Centers. I. The Case of T1N0 Disease. International Journal of Radiation Oncology, Biology, Physics, 63, 1378-1386. https://doi.org/10.1016/j.ijrobp.2005.05.018
Jones, A.S., Fish, B., Fenton, J.E. and Husband, D.J. (2004) The Treatment of Early Laryngeal Cancers (T1-T2 N0) Surgery or Irradiation? Head Neck, 26, 127-135. https://doi.org/10.1002/hed.10361
Agrawal, N. and Ha, P.K. (2008) Management of Early-Stage Laryngeal Cancer. Otolaryngologic Clinics of North America, 41, 757-769. https://doi.org/10.1016/j.otc.2008.01.014
Kim, T.G., Ahn, Y.C., Nam, H.R., Chung, M.K., Jeong, H.S., Son, Y.I., et al. (2012) Definitive Radiation Therapy for Early Glottic Cancer: Experience of Two Fractionation Schedules. Clinical and Experimental Otorhinolaryngology, 5, 94-100. https://doi.org/10.3342/ceo.2012.5.2.94
Tong, C.C., Au, K.H., Ngan, R.K., Cheung, F.Y., Chow, S.M., Fu, Y.T., et al. (2012) Definitive Radiotherapy for Early Stage Glottic Cancer by 6 MV Photons. Head & Neck Oncology, 4, 23. https://doi.org/10.1186/1758-3284-4-23
Rudoltz, M.S., Benammar, A. and Mohiuddin, M. (1993) Prognostic Factors for Local Control and Survival in T1 Squamous Cell Carcinoma of the Glottis. International Journal of Radiation Oncology, Biology, Physics, 26, 767-772. https://doi.org/10.1016/0360-3016(93)90490-M
Fein, D.A., Lee, W.R. and Hanlon, A.L. (1996) Do Overall Treatment Time, Field Size, and Treatment Energy Influence Local Control of T1-T2 Squamous Cell Carcinomas of Glottic Larynx? International Journal of Radiation Oncology, Biology, Physics, 34, 823-831. https://doi.org/10.1016/0360-3016(95)02205-8
Short, S., Krawitz, H., Macannn, A., West, T., Morton, R.P., McIvor, N.P., et al. (2006) T1N0/T2N0 Glottic Carcinoma: A Comparison of Two Fractionation Schedules. Australasian Radiology, 50, 152-157. https://doi.org/10.1111/j.1440-1673.2006.01559.x
Van der Voet, J.C., Keus, R.B., Hart, A.A., Hilgers, F.J. and Bartelink, H. (1998) The Impact of Treatment Time and Smoking on Local Control and Complications in T1 Glottic Cancer. International Journal of Radiation Oncology, Biology, Physics, 42, 247-255. https://doi.org/10.1016/S0360-3016(98)00226-0
Santaro, R., Bini, B., meccriello, G., Paiar, F. and Gallo, O. (2014) Salvage Surgery after Unsuccessful Radiotherapy in Early Glottic Cancer. B-ENT, 10, 113-120.
Piazza, C., Peretti, G., Cattaneo, A., Garrubba, F., De Zinis, L.O. and Nicolai, P. (2007) Salvage Surgery after Radiotherapy for Laryngeal Cancer: From Endoscopic Resections to Open-Neck Partial and Total Laryngectomies. Archives of Otolaryngology—Head & Neck Surgery, 133, 1037-1043. https://doi.org/10.1001/archotol.133.10.1037
Pontes, P., Brasil, O., Filho, F., Moraes, B., Pontes, A. and Neto, J. (2011) Radiotherapy for Early Glottic Cancer and Salvage Surgery after Recurrence. Brazilian Journal of Otorhinolaryngology, 77, 299-302. https://doi.org/10.1590/S1808-86942011000300005