Early-stage Glottic Laryngeal Carcinoma Research Articles

258 Radiotherapy in the Treatment of Early-Stage Glottic Laryngeal Carcinoma - Experience from a Hospital Center

258 Radiotherapy in the Treatment of Early-Stage Glottic Laryngeal Carcinoma - Experience from a Hospital Center

Impacts of Postoperative Enteral Nutrition and Rosiglitazone on Quality of Life Together with Prognosis of Patients with Early-Stage Glottic Laryngeal Carcinoma

We aimed to clarify the influence of postoperative enteral nutrition and rosiglitazone on the quality of life and prognosis of patients with early stage glottic laryngeal carcinoma. Low-temperature plasma radiofrequency ablation was performed in the control group, while the observation group additionally received rosiglitazone and postoperative enteral nutrition. After therapy, the observation group had lower fundamental frequency perturbation and amplitude perturbation and higher harmonic-to-noise ratio and effective rate than the control group. One month after treatment, the serum levels of albumin, prealbumin, and hemoglobin in the observation group were higher than those in the control group. Moreover, peripheral blood immune markers, CD3+, CD4+, and CD4+/CD8+ levels were higher in the observation group, while CD8+ levels were lower. The incidence rate of adverse reactions was lower in the observation group than in the control group. The five-year survival rates were 77.14% (27/35) and 54.29 % (19/35) in the observation and control groups, respectively. Postoperative enteral nutrition and rosiglitazone can prolong survival, improve immune function and quality of life in patients with early-stage glottic laryngeal carcinoma, and reduce adverse reactions during treatment, which is an ideal treatment plan.

Treatment Outcome of Early-stage Laryngeal Carcinoma Treated with Radical Radiotherapy Using Different Techniques: A Retrospective Study

Aim: The aim was to evaluate the treatment outcomes and prognostic characteristics of patients with early-stage glottic laryngeal carcinoma who underwent radical radiotherapy (RT) with different techniques.Materials and Methods: Radiotherapy was applied using the 2D conventional technique, 3DCRT (three dimensional conformal radiotherapy and IMRT (intensity modulated radiation therapy). Clinical T stages were 12 (48%) for T1a, 5 (20%) for T1b and 8 (32%) for T2. Stage and anterior commissure involvement were analyzed as prognostic factors. Results: There were 12 (48%) patients with T1a, 5 (20%) patients with T1b and 8 (32%) patients with T2 cancer. 5 years of overall survival and diseases free survival for T1a, T1b, T2 were found to be 91%, 80%, 62% and 91%, 80%, 62% respectively. 5 year survival for patients without and with involvement of anterior commissure was 92% and 67% respectively. Hence, showing poor survival in patients with T2 lesion or T1 lesion with involvement of anterior commissure. Conclusion: In early-stage laryngeal carcinomas, radical RT is a function sparing and effective treatment modality with excellent survival rates, regardless of treatment techniques.

Comparison of Partial Laryngectomy Versus Radiotherapy for the Treatment of Early Glottic Carcinoma: Complications and Oncological Results: A Nonrandomized Clinical Trial

The aim of this non-randomized clinical trial was to evaluate tumor outcomes and subjective quality of voice following radiotherapy and partial laryngectomy in early-stage glottic laryngeal cancers. Non-Randomized Clinical Trial. Otolaryngology and radiation oncology clinics of Imam Khomeini (an affiliated hospital of Tehran University of Medical Sciences) and Amir Aalam Hospitals. Fifteen patients with early-stage glottic laryngeal carcinoma were admitted to the otolaryngology clinic, divided into two treatment groups: radiotherapy and partial laryngectomy. Of the total 50 patients, 25 had a partial laryngectomy and 25 radiotherapies. The comparison of the average of the Voice Handicap Index (VHI) showed significant improvement of vocal quality after treatment for both partial laryngectomy and radiotherapy (P<0.0001 for both). But there was no significant difference in VHI mean scores between the two treatment groups (patients treated by partial laryngectomy and radiotherapy). Short- and long-term complication was higher in patients undergoing surgery than radiotherapy group (P<0.0001). With regard to oncological outcome after one and eight-year after treatment, no differences were observed in the two treatment groups; there was a significant relationship between smoking cessation and recurrence of disease in the partial laryngectomy treatment group (P=0.012). There was no significant difference in voice quality and life expectancy of patients operated on using open surgery and patients treated with radiotherapy in this series. Open surgery may have more noticeable complications than radiotherapy.

Transoral Laser Surgery for Early Glottic Carcinoma: A Single Surgeon Experience of 101 Consecutive Cases

Purpose: Investigate the clinical and oncological results of early-stage glottic laryngeal carcinoma patients performed by a single surgeon. Methods: This study was carried out at a tertiary academic center. A total of 101 patients were included (92 males [91.1%], 9 females [8.9%]). Mean age was 62.98 ± 10.2 years (range 33–87). Recurrence, disease-free survival, overall survival, laryngeal preservation rates were analyzed. Results: Tumor stage was Tis (carcinoma in situ) in 11 patients (10.9%), T1a in 66 patients (65.3%), T1b in 12 patients (11.9%), and T2 in 12 patients (11.9%). Postoperative pathology was squamous cell carcinoma in 69 patients (68.3%), carcinoma in situ in 26 patients (25.7%), and high-grade dysplasia in 6 patients (5.9%). Five patients (5.0%) underwent type 1, 7 (6.9%) type 2, 45 (44.6%) type 3, 24 (23.8%) type 4, 6 (5.9%) type 5a, 8 (7.9%) type 5c, 4 (4.0%) type 5d, and 2 (2.0%) type 6 cordectomy. Median follow-up time was 30 months (range 14–66). There were 5 recurrences (5.0%). Three-year disease-free survival was 94.4%. Three-year disease-free survival for stage I and II patients was 94.9 and 91.7%, respectively. Overall survival was 93.8%. Only 1 patient died related to cardiovascular disease. Disease-specific survival was 100%. Conclusions: In conclusion, this is a large case series with good oncological outcomes presented with the perspective of a single surgeon. The data of the study is in accordance with the previous reports.

The role of CD133 expression of cancer stem cells on radiotherapy response in early stage glottic cancers.

To investigate the relationship between CD133 positivity and radiotherapy (RT) response in early stage glottic laryngeal cancers. Thirty seven patients with early-stage glottic laryngeal carcinoma who were treated with primary RT were evaluated. Patients with regular follow-up of at least 3years were included in the study. Patients who had previously received chemotherapy for laryngeal surgery or underwent surgery were excluded. The patients were divided into two groups as recurrent and non-recurrent. These two groups were compared in terms of CD133 expression by immunohistochemical method. There were 37 patients in the study. Ten patients had recurrence and seven (70%) had CD133 positive and three had CD133 negative. Of 27 patients who had no recurrence, 16 (59%) had CD133 positive and 11 (41%) had CD133 negative. 7 (70%) of ten patients with recurrence were found to be positive for CD133; There was no statistically significant difference between recurrent and non-recurrent patient groups in terms of CD133 positivity (p > 0.05). There was no correlation between the final CD133 score and recurrence status as well (p > 0.05). There was no relationship between radiotherapy response and CD133 staining in early-stage glottic laryngeal cancers. It is the largest study about CD133 and RT sensitivity in early stage glottic carcinomas.

Outcome of Early-Stage Glottic Laryngeal Carcinoma Patients Treated with Radical Radiotherapy Using Different Techniques.

Purpose The aim was to evaluate the treatment outcomes and prognostic characteristics of patients with early-stage glottic laryngeal carcinoma who underwent radical radiotherapy (RT) with different techniques. Patients and Methods Radiotherapy was applied using the 2D conventional technique between 1991 and 2004 (130 patients), 3DCRT until 2014 (125 patients), and by VMAT until January 2017 (44 patients). Clinical T stages were 38 (12.7%) for Tis, 209 (69.9%) for T1, and 52 (17.4%) for T2. Radiotherapy technique and energy, anterior commissure involvement, and stage were analyzed as prognostic factors. Results The median total dose was 66 (50–70) Gy, and median follow-up time was 72 (3–288) months; 5-year disease-specific survival (DSS) rates were 95.8%, 95.5%, and 88.6%, respectively, in Tis, T1, and T2 stages. In multivariate analyses, anterior commissure involvement was found significant for all survival and local control rates. The patients treated with VMAT technique had better local control and DSS rates. However, these results were not statistically significant. Conclusion In early-stage laryngeal carcinomas, radical RT is a function sparing and effective treatment modality, regardless of treatment techniques.

Outcomes of radiotherapy in early stage glottic laryngeal carcinoma: a single center experience

Our aim was to determine the treatment outcomes and the prognostic factors affecting local control in early stage glottic carcinoma (ESGC) treated with definitive radiotherapy (RT). Between April 2003 and May 2015, 76 patients with ESGC were treated at Inonu University Hospital. There were 58 patients with T1a, 7 T1b and 11 with T2 tumors. Twenty-two patients were treated with conformal radiotherapy, 31 patients were treated with conventional RT and 23 patients were treated with intensity modulated radiotherapy as initial treatment. During a median follow-up of 51 months (range 6-136), 11 patients had failures. Five year overall survival rates were 73.7% in T1 and 81.8% T2. Local control rate was 85.5% in our patients. Patients who were over 61 years had significantly lower local control (p = 0.042). One patient treatment was interrupted because of grade 3 edema. One patient had grade 3 dermatitis, 2 patients grade 3 mucositis and 4 patients grade 3 edema, respectively. Our results suggest that curative radiotherapy is an effective treatment modality in ESGC without increasing toxicity. Age proved to be the only independent prognostic factor affecting local control after primary radiotherapy according to the results of this study.

Erken evre glottik larenks kanserinde radyoterapi sonuçları: Tek merkez deneyimi

Erken evre glottik larenks kanseri tanisi ile kuratif radyoterapi uygulanmis olgularda geriye donuk olarak tedavi sonuclarinin ve prognostik faktorlerin degerlendirilmesi amaclandi. 1993-2010 yillari arasinda klinigimizde radyoterapi uygulanan, biyopsi ile histopatolojik olarak kanser tanisi dogrulanmis ve RT oncesi herhangi bir tedavi uygulanmamis erken evre (T1-2N0) glottik larenks kanserli 73 olgu geriye donuk olarak incelendi. Tum olgularin verileri guncellenerek hasta, tumor ve tedaviye ait parametrelerin lokal-bolgesel kontrol ve sagkalim uzerine olan etkileri arastirildi. Hastalarin medyan yasi 60 (37-83) olup 69’u erkek, 4’u kadindir. Evrelere gore dagilim; 41’i (% 56,2) T1a, 8’i (% 10,9) T1b, 24’u (% 32,9) T2 seklindedir. Hastalara medyan 66 Gy (58,5-72) eksternal radyoterapi uygulanmistir. Radyoterapiye bagli olarak, 1 olguda (% 1,4) grade 3-4 erken ve gec larengeal odem gelismis, bu olgu disinda diger olgularin hicbirinde grade 3-4 erken ve gec toksisite ile karsilasilmamistir. Medyan 73 (5-209) aylik takipte toplam 10 (% 13,7) hastada lokal-bolgesel nuks saptanmis, hicbir olguda uzak metastaz saptanmamistir. Hastalarin 5 yillik lokal-bolgesel kontrol, hastaliga ozgu sagkalim ve genel sagkalim orani sirasi ile % 85, % 92 ve % 78’dir. Incelenen faktorlerden “tedaviye 5 gun ve daha fazla ara verilmesi” lokal-bolgesel kontrol ve hastaliga ozgu sagkalimi anlamli olarak azaltirken (sirasi ile p=0,008, p=0,036), “tedavi oncesi ses kisikligi suresinin 5 aydan az olmasinin” sadece lokal-bolgesel kontrolu anlamli olarak azalttigi (p=0,036) saptanmistir. Sonuc olarak, erken evre glottik larenks kanserinde primer tedavi olarak radyoterapi yuksek lokal kontrol oranlarina sahip etkin bir tedavi seklidir. Radyoterapiye cesitli nedenlerden dolayi verilen aralar lokal-bolgesel kontrolu ve hastaliga ozgu sagkalimi olumsuz etkileyen prognostik bir faktordur. Bu nedenle tedavi aralarindan mumkun oldugunca kacinilmalidir. Results of radiotherapy in early stage glottic laryngeal carcinoma: A single center experience Patients with early stage glottic laryngeal cancer treated with curative radiotherapy were aimed to evaluate retrospectively for their treatment results and prognostic factors. In between 1993-2010, early stage (T1-2N0) 73 glottic laryngeal cancer cases which were treated with radiotherapy in our department that histopathological diagnosis of cancer was confirmed by biopsy and without any treatment prior to RT, were retrospectively analyzed. Patient, tumor and treatment parameters of all cases were updated and their effects on the local-regional control and survival were investigated. The median age of patients was 60 (37-83) and 69 patients were male and 4 were female. The distributions of patients according to stages were as follows: 41 (56.2% ) T1a, 8 (10.9% ) T1b and 24 (32.9% ) T2. Median of 66 Gy (58.5-72) of external beam radiotherapy was delivered to patients. In a patient (1.4% ), grade 3-4 early and late laryngeal edema depending on radiotherapy was developed. In other patients except from this patient, early and late grade 3-4 toxicity was not observed. During a median 73 months (5-209) follow-up, local recurrence was detected in 10 (13.7% ) cases and no distant metastasis was observed. Five year local-regional control, disease-specific and overall survival rates were 85% , 92% and 78% , respectively. From the investigated factors, while 5 or more days treatment interruption was found to decrease significantly local-regional control and disease-specific survival (p=0.008, p=0.036, respectively), less than 5 months duration of hoarseness was found to decrease significantly only local-regional control (p=0.036). In conclusion, radiotherapy as primary treatment modality in the early stage laryngeal cancer is an effective form of treatment with high rates of local control. Radiotherapy interruption due to various reasons is a prognostic factor which adversely effects loco-regional control and disease-specific survival. Therefore, interruptions during the radiotherapy should be avoided as much as possible. J. Exp. Clin. Med., 2012; 29:141-147

Higher laryngeal preservation rate after CO2 laser surgery compared with radiotherapy in T1a glottic laryngeal carcinoma

Clinical outcome of endoscopic CO(2) laser surgery and radiotherapy in early-stage glottic laryngeal carcinoma is difficult to compare because of differences in treatment selection and patient groups. Therefore, we compared local control, overall survival, and laryngeal preservation in a homogenous group of patients with T1a glottic carcinoma with normal/diminished mucosal wave treated with either CO(2) laser surgery or radiotherapy. Retrospective survival analysis was performed on 100 patients with T1a glottic carcinoma treated with CO(2) laser surgery (n = 49) or radiotherapy (n = 51), diagnosed at the University Medical Center Groningen between 1990 and 2004. No significant differences in local control and overall survival were found. Ultimate 5-year laryngeal preservation was significantly better in the CO(2) laser surgery group (95% vs 77%, p = .043). Patients with T1a glottic carcinoma with normal/diminished mucosal wave treated with CO(2) laser surgery had a significantly better laryngeal preservation rate than patients treated with radiotherapy.