Clinical Predictors of Laryngeal Preservation Rate in Stage III-IV Laryngeal Cancer and Hypopharyngeal Cancer Patients Treated with Organ Preservation |
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| Authors: | Kanograt Tangsriwong1Tastsanachart Jitreetat2 |
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| Affiliation: | 1Department of Radiation Oncology, Rajavithi Hospital, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.2Department of Otolaryngology, Head and Neck Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand. |
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| Abstract: | Purpose: To determine factors affecting laryngeal preservation rate in laryngeal and hypopharyngeal cancer patientstreated with organ preservation. Material and Methods: Retrospective study examining stage III to IV laryngeal andhypopharyngeal cancer patients who have been treated with organ preservation. Conventional radiation must be appliedin all patients with minimum dose of 45 Gray. Weekly or triweekly chemotherapy can be adding during radiation. Salvagesurgery should be considered in residual disease or local recurrence. Kaplan-Meier was used for survival analysis and,Log rank test and Cox proportional hazard test were used for uni and multivariate analysis. Results: From January2010 to October 2014, there were 69 patients treated with laryngeal preservation and 53 patients received radiationdose 61-70 Gray. After completing radiation, we found that 44 patients have no residual tumor within 6 months and33 patients can preserve their functional larynx later with complete response (median follow up 6 mo, range 0-46.3mo). The 1-year, 2-year and 3-year laryngeal preservation rate was 49%, 36 % and 32 % respectively. On univariateanalysis, lower nodal stage (p = 0.008), stage III disease (p = 0.046), tumor volume cord involvement (p = 0.016), dose 61-70 Gray (p < 0.001) and no interruption of treatment (p = 0.017) have betterlaryngeal preservation rates. ECOG performance status 2, higher nodal stage, stage IV, presence of true vocal cordinvolvement, upper airway obstruction before/during radiation and radiation dose below 61-70 Gray had an effect onworse overall survival when evaluated with univariate analysis statistical significance. Conclusion: For factors thataffected laryngeal preservation in our study were nodal stage, group stage, tumor volume, true vocal cord involvement,radiation dose and treatment break time more than one week with statistical significance. |
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| Keywords: | Keywords:clinical predictor laryngeal preservation laryngeal cancer Hypopharyngeal cancer survival outcomes |
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