Supraglottic laryngeal carcinoma: An analysis of dose-time-volume factors in 410 patients

Harwood, Andrew R.; Beale, Frank A.; Cummings, Bernard; Keane, Thomas J.; Payne, David G.; Rider, W.D.; Rawlinson, Ellen; Elhakim, T

doi:10.1016/0360-3016(83)90289-4

Cited by 104 publications

(25 citation statements)

References 6 publications

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“…An examiners' preference for larynx preservation at 40 Gy might also have been present, although the criteria for patient selection at 40 Gy was the same between the two arms. Although these possible biases might have led to better results for the CRT arm, the larynx preservation rate of 75% for T 2 supraglottic carcinoma in this study compares favorably to reported results by RT alone, with preservation rates ranging from 59 to 83% [1,6,7,15,36,37]. Our study implies, at least, that CRT is useful for larynx preservation in a setting where treatment decisions are made during radiotherapy, a system which is actually being employed in many institutions [1,2,[4][5][6][7][8] for head and neck cancer.…”

Section: Discussionsupporting

confidence: 65%

A Phase II Study of Concomitant Chemoradiotherapy for Laryngeal Carcinoma Using Carboplatin

Nishioka¹,

Shirato²,

Fukuda³

et al. 1999

Oncology

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Purpose: We conducted a phase II study of concomitant chemoradiotherapy with carboplatin for laryngeal carcinoma. Materials and Methods: Sixty-four patients with stage II–IV (stage II, 36; III, 19; IV 9) laryngeal carcinoma were treated with concomitant administration of carboplatin (CBDCA) during radiotherapy (CRT group) between 1991 and 1994. There were 36 supraglottic, 25 glottic, and 3 subglottic carcinomas. Patients with stage II and stage III–IV received intravenous CBDCA of 100 mg/m² and 120 mg/m² once a week, respectively. Tumor response was assessed at 40 Gy in 16 fractions to select the patients suitable for total laryngectomy or radical radiotherapy of 65 Gy in 26 fractions in 6.5 weeks. The treatment results were compared with the historical control consisting of 56 patients consecutively treated from 1988 to 1990 without chemotherapy (RT group). The two studies were comparable with regard to patient characteristics, including age distribution, gender, tumor location, size, and clinical stage. Results: The actuarial 5-year survival rate was 80.3% for the CRT group and 81.3% for the RT group. A favorable response (complete response or partial response) at 40 Gy was observed in 87.5% of the patients of the CRT group and in 62.5% of the patients of the RT group (χ² = 7.566, p < 0.01). The actuarial 5-year larynx preservation rate for the CRT group (75%) was significantly higher than that for the RT group (57%) in patients with T₂ supraglottic carcinoma (p < 0.05). There was no difference in the larynx preservation rate between the two treatment arms for any T stage of glottic carcinomas. Conclusion: CRT using carboplatin improved the tumor response at 40 Gy and consequently achieved a higher larynx preservation rate for T₂ supraglottic carcinoma. A clinical randomized trial is indicated to certify the findings of this phase II study.

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Section: Discussionsupporting

confidence: 65%

A Phase II Study of Concomitant Chemoradiotherapy for Laryngeal Carcinoma Using Carboplatin

Nishioka¹,

Shirato²,

Fukuda³

et al. 1999

Oncology

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“…1 In the case of T1 and T2 supraglottic carcinoma the 5-year local control for radiation lies around 75%. [2][3][4][5][6] Partial surgery is the other option for early laryngeal carcinoma, and the controversy between surgery and radiotherapy as the best therapeutic approach continues. In recent years, endoscopic laser surgery has emerged as an option to classical open partial surgery.…”

mentioning

confidence: 99%

Endoscopic laser surgery in the treatment of radiation failure of early laryngeal carcinoma

et al. 2000

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“…The expected local control rate exceeded 70%, and median survival time was 5 years or more after conventional or accelerated fractionation radiotherapy alone followed by salvage surgery. 23,25,27,29,30,34,37,39,40 Originally, the numbers required for the sample size to show the superiority of the investigational chemoradiotherapy arm were prohibitive. This became ethically inappropriate when the chemoradiotherapy was too toxic, against the current standard of radiotherapy alone.…”

Section: Treatment Results After Radiotherapy Alonementioning

confidence: 99%

“…A number of large retrospective analyses were conducted during the 1960s to 1980s regarding dose-response relationships for tumor control and normal tissue complications in HNSCC. According to the literature, radiotherapy alone, administered at 60-75 Gy/6-7.5 weeks for T2 disease achieved 70%-80ϩ% of local control at 2 to 5 years for cancer of the oropharynx, 25-33 60%-75ϩ% for the larynx, [34][35][36][37] and 40%-70ϩ% for the hypopharynx. [38][39][40][41][42][43] The reported local control rates for patients with T3-T4 tumors, and survival rates for stage III/IV non-nasopharyngeal HNSCC varied widely, as shown in Table 1.…”

Section: Treatment Results After Radiotherapy Alonementioning

confidence: 99%

Chemoradiotherapy for head and neck cancer: current status and perspectives

Kawashima

2004

Int J Clin Oncol

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Chemoradiotherapy for head and neck cancer has achieved remarkable progress in the past two decades. This progress has resulted in efforts to redefine the standard of care for patients with this disease. A brief review of the history of current chemoradiotherapy was conducted to clarify the rationale for this approach. An attempt was made to present problems that remain to be solved. The review showed that chemoradiotherapy for head and neck cancer is now becoming a vital treatment option for patients with advanced disease. Currently available and upcoming data are about to clarify important issues regarding proper patient selection, standard procedures, management of toxicities, ultimate cure, and quality of life. This newly developed and promising treatment option has, however, confounding problems to be solved. Meticulous collaboration in an experienced multidisciplinary team is required to address these problems and to spread this approach in daily clinical practice.

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Supraglottic laryngeal carcinoma: An analysis of dose-time-volume factors in 410 patients

Cited by 104 publications

References 6 publications

A Phase II Study of Concomitant Chemoradiotherapy for Laryngeal Carcinoma Using Carboplatin

A Phase II Study of Concomitant Chemoradiotherapy for Laryngeal Carcinoma Using Carboplatin

Endoscopic laser surgery in the treatment of radiation failure of early laryngeal carcinoma

Chemoradiotherapy for head and neck cancer: current status and perspectives

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