Multimodal treatment for t1-2 supraglottic cancer: the impact of tumor location

To examine the outcome and prognostic factors after multimodal treatment of T1-2 supraglottic cancer. We analyzed 49 patients with T1-2 supraglottic cancer who received multimodal treatment between 1990 and 2011. Their age range was 43-86 years (median=66 years). Fifteen patients had a T1 tumor and...

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Veröffentlicht in:Anticancer research 2014-01, Vol.34 (1), p.203-207
Hauptverfasser: Suzuki, Gen, Yamazaki, Hideya, Ogo, Etsuyo, Abe, Toshi, Hayabuchi, Naofumi, Umeno, Hirohito, Nakashima, Tadashi, Nakamura, Satoaki, Yoshida, Ken
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container_issue 1
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container_title Anticancer research
container_volume 34
creator Suzuki, Gen
Yamazaki, Hideya
Ogo, Etsuyo
Abe, Toshi
Hayabuchi, Naofumi
Umeno, Hirohito
Nakashima, Tadashi
Nakamura, Satoaki
Yoshida, Ken
description To examine the outcome and prognostic factors after multimodal treatment of T1-2 supraglottic cancer. We analyzed 49 patients with T1-2 supraglottic cancer who received multimodal treatment between 1990 and 2011. Their age range was 43-86 years (median=66 years). Fifteen patients had a T1 tumor and 34 had a T2 tumor (40 N0, 3 N1, 4 N2, and 2 N3). Debulking using transoral laser excision was employed in 25 patients. Neck dissection was performed in four patients. Chemotherapy was administered to 29 patients: intra-arterial infusion in four and systemic infusion in 25. Radiotherapy was administered at a median dose of 64.8 Gy (range=30-70 Gy) with once- or twice-daily fractionation. Median follow-up time was 60 months (range=12-153 months). Two patients interrupted radiotherapy because of a poor response at 30 Gy (T2N2) and 49.9 Gy (T2N0). They underwent total laryngectomy and were still alive without any evidence of cancer 48 and 28 months after treatment, respectively. The other 47 patients (96%) had a complete local response to treatment. Locoregional failure was observed in six tumor sites, and one patient had simultaneous locoregional recurrence. The 5-year local control, disease-free, overall survival, and laryngeal preservation rates were 82%, 74%, 82%, and 90%, respectively. The location of a primary tumor within the supraglottis (epilarynx or elsewhere) was identified as the only factor predictive of progression-free survival by univariate and multivariate analyses (p=0.04). Acute adverse reactions of grade 3 or more were: one grade 3 laryngeal edema, one grade 3 dyspnea, and one grade 5 hematological toxicity (disseminated intravascular coagulation). Among late adverse events, one grade 1, one grade 2 hoarseness, and grade 3 laryngeal necrosis were observed. Multimodal radiotherapy produced a good outcome. Localization of the tumor in the epilarynx was associated with a better progression-free survival rate than that in the other parts of the supraglottis.
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Yamazaki, Hideya ; Ogo, Etsuyo ; Abe, Toshi ; Hayabuchi, Naofumi ; Umeno, Hirohito ; Nakashima, Tadashi ; Nakamura, Satoaki ; Yoshida, Ken</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-1a4f8c8370718c3228f121dec8770b4e7398dc92ccaa9f3387d024a036f8d4933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Cisplatin - administration &amp; dosage</topic><topic>Combined Modality Therapy</topic><topic>Dose Fractionation</topic><topic>Female</topic><topic>Fluorouracil - administration &amp; dosage</topic><topic>Follow-Up Studies</topic><topic>Glottis - pathology</topic><topic>Humans</topic><topic>Laryngeal Neoplasms - mortality</topic><topic>Laryngeal Neoplasms - pathology</topic><topic>Laryngeal Neoplasms - therapy</topic><topic>Laryngectomy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - therapy</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Radiotherapy Dosage</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suzuki, Gen</creatorcontrib><creatorcontrib>Yamazaki, Hideya</creatorcontrib><creatorcontrib>Ogo, Etsuyo</creatorcontrib><creatorcontrib>Abe, Toshi</creatorcontrib><creatorcontrib>Hayabuchi, Naofumi</creatorcontrib><creatorcontrib>Umeno, Hirohito</creatorcontrib><creatorcontrib>Nakashima, Tadashi</creatorcontrib><creatorcontrib>Nakamura, Satoaki</creatorcontrib><creatorcontrib>Yoshida, Ken</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Anticancer research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suzuki, Gen</au><au>Yamazaki, Hideya</au><au>Ogo, Etsuyo</au><au>Abe, Toshi</au><au>Hayabuchi, Naofumi</au><au>Umeno, Hirohito</au><au>Nakashima, Tadashi</au><au>Nakamura, Satoaki</au><au>Yoshida, Ken</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multimodal treatment for t1-2 supraglottic cancer: the impact of tumor location</atitle><jtitle>Anticancer research</jtitle><addtitle>Anticancer Res</addtitle><date>2014-01</date><risdate>2014</risdate><volume>34</volume><issue>1</issue><spage>203</spage><epage>207</epage><pages>203-207</pages><eissn>1791-7530</eissn><abstract>To examine the outcome and prognostic factors after multimodal treatment of T1-2 supraglottic cancer. We analyzed 49 patients with T1-2 supraglottic cancer who received multimodal treatment between 1990 and 2011. Their age range was 43-86 years (median=66 years). Fifteen patients had a T1 tumor and 34 had a T2 tumor (40 N0, 3 N1, 4 N2, and 2 N3). Debulking using transoral laser excision was employed in 25 patients. Neck dissection was performed in four patients. Chemotherapy was administered to 29 patients: intra-arterial infusion in four and systemic infusion in 25. Radiotherapy was administered at a median dose of 64.8 Gy (range=30-70 Gy) with once- or twice-daily fractionation. Median follow-up time was 60 months (range=12-153 months). Two patients interrupted radiotherapy because of a poor response at 30 Gy (T2N2) and 49.9 Gy (T2N0). They underwent total laryngectomy and were still alive without any evidence of cancer 48 and 28 months after treatment, respectively. The other 47 patients (96%) had a complete local response to treatment. Locoregional failure was observed in six tumor sites, and one patient had simultaneous locoregional recurrence. The 5-year local control, disease-free, overall survival, and laryngeal preservation rates were 82%, 74%, 82%, and 90%, respectively. The location of a primary tumor within the supraglottis (epilarynx or elsewhere) was identified as the only factor predictive of progression-free survival by univariate and multivariate analyses (p=0.04). Acute adverse reactions of grade 3 or more were: one grade 3 laryngeal edema, one grade 3 dyspnea, and one grade 5 hematological toxicity (disseminated intravascular coagulation). Among late adverse events, one grade 1, one grade 2 hoarseness, and grade 3 laryngeal necrosis were observed. Multimodal radiotherapy produced a good outcome. Localization of the tumor in the epilarynx was associated with a better progression-free survival rate than that in the other parts of the supraglottis.</abstract><cop>Greece</cop><pmid>24403463</pmid><tpages>5</tpages></addata></record>
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source MEDLINE; EZB-FREE-00999 freely available EZB journals
subjects Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - therapy
Cisplatin - administration & dosage
Combined Modality Therapy
Dose Fractionation
Female
Fluorouracil - administration & dosage
Follow-Up Studies
Glottis - pathology
Humans
Laryngeal Neoplasms - mortality
Laryngeal Neoplasms - pathology
Laryngeal Neoplasms - therapy
Laryngectomy
Male
Middle Aged
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - therapy
Neoplasm Staging
Prognosis
Radiotherapy Dosage
Survival Rate
title Multimodal treatment for t1-2 supraglottic cancer: the impact of tumor location
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