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Erschienen in: European Archives of Oto-Rhino-Laryngology 3/2012

01.03.2012 | Laryngology

Predictors of radiotherapy outcome in patients with T2 supraglottic carcinoma

verfasst von: Tomasz Rutkowski, A. Wygoda, K. Składowski, B. Hejduk, R. Rutkowski, B. Lukaszczyk-Widel, M. Hutnik, B. Maciejewski

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 3/2012

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Abstract

The decision regarding treatment of early supraglottic carcinoma remains controversial. Single institution clinical data of patients with T2 supraglottic carcinoma treated exclusively with radiotherapy in terms of prognostic factors and treatment results were analyzed. Patient-related factors that would potentially by useful for optimal therapeutic decision to be undertaken were especially investigated. Between 1994 and 2004, 78 patients with T2 supraglottic carcinoma underwent radiotherapy (RT) in Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Poland. There were 54 (69%) males and 24 (31%) females in the median age of 61 years. There were 17 (22%) patients with N+. Median body mass of patients before (BM0) and after RT (BM1) was 74 kg (range 45.2–130 kg) and 72.9 kg (range 49.9–122.5 kg), respectively. Median hemoglobin concentrations before (Hb0) and after (Hb1) RT were 14.3 and 13.4 g/dl, respectively. Median change of Hb concentration during RT (dHb) was −0.8 g/dl. All were treated up to total doses (TD) ranged from 62.5 to 72 Gy. The overall treatment time (OTT) ranged from 30 to 70 days. Estimates of local control (LC), ultimate local control (uLC), and overall survival (OS) were calculated using the Kaplan–Meier method. Log rank statistics, Cox proportional hazard model and step-wise Cox regression hazard model were employed to identify prognostic factors for LC, uLC, and OS in univariate and multivariate analyses. The 5-year LC, RC, uLC and OS rates were 85, 92, 88, and 56%, respectively. In multivariate analysis N+ (p = 0.01) and prolonged OTT (p = 0.03) significantly decreased LC. Females (p = 0.02), higher BM0 (p = 0.03), and HB0 (p = 0.006) significantly prolonged OS. Patient-related factors like gender, hemoglobin concentration, and body mass may predict treatment outcome. Radiotherapy is effective for T2 supraglottic carcinoma of the larynx unless higher dose intensity is provided. Involved regional lymph nodes significantly deteriorate locoregional cure.
Literatur
1.
Zurück zum Zitat Dinapoli N, Parrilla C, Galli J et al (2010) Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in a homogenous patient population. Strahlenther Onkol 186:607–613PubMedCrossRef Dinapoli N, Parrilla C, Galli J et al (2010) Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in a homogenous patient population. Strahlenther Onkol 186:607–613PubMedCrossRef
2.
Zurück zum Zitat Goudakos JK, Markou K, Nikolaou A, Themelis C, Vital V (2009) Management of the clinically negative neck (N0) of supraglottic laryngeal carcinoma: a systematic review. Eur J Surg Oncol 35:223–229PubMedCrossRef Goudakos JK, Markou K, Nikolaou A, Themelis C, Vital V (2009) Management of the clinically negative neck (N0) of supraglottic laryngeal carcinoma: a systematic review. Eur J Surg Oncol 35:223–229PubMedCrossRef
3.
Zurück zum Zitat Mendenhall WM, Million RR, Cassisi NJ (1984) Squamous cell carcinoma of the supraglottic larynx treated with radical irradiation: analysis of treatment parameters and results. Int J Radiat Oncol Biol Phys 10:2223–2230PubMedCrossRef Mendenhall WM, Million RR, Cassisi NJ (1984) Squamous cell carcinoma of the supraglottic larynx treated with radical irradiation: analysis of treatment parameters and results. Int J Radiat Oncol Biol Phys 10:2223–2230PubMedCrossRef
4.
Zurück zum Zitat Olthoff A, Ewen A, Wolff HA et al (2009) Organ function and quality of life after transoral laser microsurgery and adjuvant radiotherapy for locally advanced laryngeal cancer. Strahlenther Onkol 185:303–309PubMedCrossRef Olthoff A, Ewen A, Wolff HA et al (2009) Organ function and quality of life after transoral laser microsurgery and adjuvant radiotherapy for locally advanced laryngeal cancer. Strahlenther Onkol 185:303–309PubMedCrossRef
5.
Zurück zum Zitat Sessions DG, Lenox J, Spector GJ (2005) Supraglottic laryngeal cancer: analysis of treatment results. Laryngoscope 115:1402–1410PubMedCrossRef Sessions DG, Lenox J, Spector GJ (2005) Supraglottic laryngeal cancer: analysis of treatment results. Laryngoscope 115:1402–1410PubMedCrossRef
6.
Zurück zum Zitat Dische S, Warburton MF, Jones D, Lartigau E (1989) The recording of morbidity related to radiotherapy. Radiother Oncol 16:103–108PubMedCrossRef Dische S, Warburton MF, Jones D, Lartigau E (1989) The recording of morbidity related to radiotherapy. Radiother Oncol 16:103–108PubMedCrossRef
7.
Zurück zum Zitat Petrović Z, Krejović B, Janosević S (1997) Occult metastases from supraglottic laryngeal carcinoma. Clin Otolaryngol Allied Sci 22:522–524PubMedCrossRef Petrović Z, Krejović B, Janosević S (1997) Occult metastases from supraglottic laryngeal carcinoma. Clin Otolaryngol Allied Sci 22:522–524PubMedCrossRef
8.
Zurück zum Zitat Wang CC, Suit HD, Blitzer PH (1986) Twice-a-day radiation therapy for supraglottic carcinoma. Int J Radiat Oncol Biol Phys 12:3–7PubMedCrossRef Wang CC, Suit HD, Blitzer PH (1986) Twice-a-day radiation therapy for supraglottic carcinoma. Int J Radiat Oncol Biol Phys 12:3–7PubMedCrossRef
9.
Zurück zum Zitat Sykes AJ, Slevin NJ, Gupta NK, Brewster AE (2000) 331 cases of clinically node-negative supraglottic carcinoma of the larynx: a study of a modest size fixed field radiotherapy approach. Int J Radiat Oncol Biol Phys 46:1109–1115PubMedCrossRef Sykes AJ, Slevin NJ, Gupta NK, Brewster AE (2000) 331 cases of clinically node-negative supraglottic carcinoma of the larynx: a study of a modest size fixed field radiotherapy approach. Int J Radiat Oncol Biol Phys 46:1109–1115PubMedCrossRef
10.
Zurück zum Zitat Wendt CD, Peters LJ, Ang KK et al (1989) Hyperfractionated radiotherapy in the treatment of squamous cell carcinomas of the supraglottic larynx. Int J Radiat Oncol Biol Phys 17:1057–1062PubMedCrossRef Wendt CD, Peters LJ, Ang KK et al (1989) Hyperfractionated radiotherapy in the treatment of squamous cell carcinomas of the supraglottic larynx. Int J Radiat Oncol Biol Phys 17:1057–1062PubMedCrossRef
11.
Zurück zum Zitat Nakfoor BM, Spiro IJ, Wang CC, Martins P, Montgomery W, Fabian R (1998) Results of accelerated radiotherapy for supraglottic carcinoma: a Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary experience. Head Neck 20:379–384PubMedCrossRef Nakfoor BM, Spiro IJ, Wang CC, Martins P, Montgomery W, Fabian R (1998) Results of accelerated radiotherapy for supraglottic carcinoma: a Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary experience. Head Neck 20:379–384PubMedCrossRef
12.
Zurück zum Zitat Chan AW, Ancukiewicz M, Carballo N, Montgomery W, Wang CC (2001) The role of postradiotherapy neck dissection in supraglottic carcinoma. Int J Radiat Oncol Biol Phys 50:367–375PubMedCrossRef Chan AW, Ancukiewicz M, Carballo N, Montgomery W, Wang CC (2001) The role of postradiotherapy neck dissection in supraglottic carcinoma. Int J Radiat Oncol Biol Phys 50:367–375PubMedCrossRef
13.
Zurück zum Zitat Inoue T, Inoue T, Ikeda H et al (1993) Comparison of early glottic and supraglottic carcinoma treated with conventional fractionation of radiotherapy. Strahlenther Onkol 169:584–589PubMed Inoue T, Inoue T, Ikeda H et al (1993) Comparison of early glottic and supraglottic carcinoma treated with conventional fractionation of radiotherapy. Strahlenther Onkol 169:584–589PubMed
14.
Zurück zum Zitat Maciejewski B (1987) Regression rate of metastatic neck lymph nodes after radiation treatment as a prognostic factor for local control. Radiother Oncol 8:301–308PubMedCrossRef Maciejewski B (1987) Regression rate of metastatic neck lymph nodes after radiation treatment as a prognostic factor for local control. Radiother Oncol 8:301–308PubMedCrossRef
15.
Zurück zum Zitat Wall TJ, Peters LJ, Brown BW, Oswald MJ, Milas L (1985) Relationship between lymph nodal status and primary tumor control probability in tumors of the supraglottic larynx. Int J Radiat Oncol Biol Phys 11:1895–1902PubMedCrossRef Wall TJ, Peters LJ, Brown BW, Oswald MJ, Milas L (1985) Relationship between lymph nodal status and primary tumor control probability in tumors of the supraglottic larynx. Int J Radiat Oncol Biol Phys 11:1895–1902PubMedCrossRef
16.
Zurück zum Zitat Bourhis J, Overgaard J, Audry H et al (2006) Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Meta-Analysis of Radiotherapy in Carcinomas of Head and neck (MARCH) Collaborative Group. Lancet 368:843–854PubMedCrossRef Bourhis J, Overgaard J, Audry H et al (2006) Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Meta-Analysis of Radiotherapy in Carcinomas of Head and neck (MARCH) Collaborative Group. Lancet 368:843–854PubMedCrossRef
17.
Zurück zum Zitat Posner MR, Hershock DM, Blajman CR et al (2007) TAX 324 Study Group. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357:1705–1715PubMedCrossRef Posner MR, Hershock DM, Blajman CR et al (2007) TAX 324 Study Group. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357:1705–1715PubMedCrossRef
18.
Zurück zum Zitat Vermorken JB, Remenar E, van Herpen C et al (2007) EORTC 24971/TAX 323 Study Group. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357:1695–1704PubMedCrossRef Vermorken JB, Remenar E, van Herpen C et al (2007) EORTC 24971/TAX 323 Study Group. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357:1695–1704PubMedCrossRef
19.
Zurück zum Zitat Levi F, La Vecchia C, Lucchini F, Negri E (1992) Trends in cancer mortality sex ratios in Europe, 1950–1989. World Health Stat Q 45:117–164PubMed Levi F, La Vecchia C, Lucchini F, Negri E (1992) Trends in cancer mortality sex ratios in Europe, 1950–1989. World Health Stat Q 45:117–164PubMed
20.
Zurück zum Zitat Carl J, Andersen LJ, Pedersen M, Greisen O (1996) Prognostic factors of local control after radiotherapy in T1 glottic and supraglottic carcinoma of the larynx. Radiother Oncol 39:229–233PubMedCrossRef Carl J, Andersen LJ, Pedersen M, Greisen O (1996) Prognostic factors of local control after radiotherapy in T1 glottic and supraglottic carcinoma of the larynx. Radiother Oncol 39:229–233PubMedCrossRef
21.
Zurück zum Zitat Tarnawski R, Skladowski K, Maciejewski B (1997) Prognostic value of hemoglobin concentration in radiotherapy for cancer of supraglottic larynx. Int J Radiat Oncol Biol Phys 38:1007–2011PubMedCrossRef Tarnawski R, Skladowski K, Maciejewski B (1997) Prognostic value of hemoglobin concentration in radiotherapy for cancer of supraglottic larynx. Int J Radiat Oncol Biol Phys 38:1007–2011PubMedCrossRef
22.
Zurück zum Zitat Greisen O, Carl J, Pedersen M (1997) A consecutive series of patients with laryngeal carcinoma treated by primary irradiation. Acta Oncol 36:279–282PubMedCrossRef Greisen O, Carl J, Pedersen M (1997) A consecutive series of patients with laryngeal carcinoma treated by primary irradiation. Acta Oncol 36:279–282PubMedCrossRef
23.
Zurück zum Zitat Rutkowski T, Suwinski R, Idasiak A (2007) The prognostic value of hemoglobin concentration in postoperative radiotherapy of 835 patients with laryngeal cancer. Int J Radiat Oncol Biol Phys 69:1018–1023PubMedCrossRef Rutkowski T, Suwinski R, Idasiak A (2007) The prognostic value of hemoglobin concentration in postoperative radiotherapy of 835 patients with laryngeal cancer. Int J Radiat Oncol Biol Phys 69:1018–1023PubMedCrossRef
24.
Zurück zum Zitat Składowski K, Zajusz A, Swiatnicka J et al (1996) Prognostic factors in radiotherapy of supraglottic cancer. Otolaryngol Pol 50:579–586PubMed Składowski K, Zajusz A, Swiatnicka J et al (1996) Prognostic factors in radiotherapy of supraglottic cancer. Otolaryngol Pol 50:579–586PubMed
25.
Zurück zum Zitat van Acht MJ, Hermans J, Boks DE, Leer JW (1992) The prognostic value of hemoglobin and a decrease in hemoglobin during radiotherapy in laryngeal carcinoma. Radiother Oncol 23:229–235PubMedCrossRef van Acht MJ, Hermans J, Boks DE, Leer JW (1992) The prognostic value of hemoglobin and a decrease in hemoglobin during radiotherapy in laryngeal carcinoma. Radiother Oncol 23:229–235PubMedCrossRef
26.
Zurück zum Zitat Hoff CM, Lassen P, Eriksen JG, Hansen HS, Specht L et al (2011) Does transfusion improve the outcome for HNSCC patients treated with radiotherapy? - Results from the randomized DAHANCA 5 and 7 trials. Acta Oncol (in press) Hoff CM, Lassen P, Eriksen JG, Hansen HS, Specht L et al (2011) Does transfusion improve the outcome for HNSCC patients treated with radiotherapy? - Results from the randomized DAHANCA 5 and 7 trials. Acta Oncol (in press)
27.
Zurück zum Zitat Hoff CM, Hansen HS, Overgaard M et al (2010) The importance of haemoglobin level and effect of transfusion in HNSCC patients treated with radiotherapy: Results from the randomized DAHANCA 5 study. Radiother Oncol 98:28–33PubMedCrossRef Hoff CM, Hansen HS, Overgaard M et al (2010) The importance of haemoglobin level and effect of transfusion in HNSCC patients treated with radiotherapy: Results from the randomized DAHANCA 5 study. Radiother Oncol 98:28–33PubMedCrossRef
28.
Zurück zum Zitat McRackan TR, Watkins JM, Herrin AE et al (2008) Effect of body mass index on chemoradiation outcomes in head and neck cancer. Laryngoscope 118:1180–1185PubMedCrossRef McRackan TR, Watkins JM, Herrin AE et al (2008) Effect of body mass index on chemoradiation outcomes in head and neck cancer. Laryngoscope 118:1180–1185PubMedCrossRef
29.
Zurück zum Zitat Brookes GB (1985) Nutritional status: a prognostic indicator in head and neck cancer. Otolaryngol Head Neck Surg 93:69–74PubMed Brookes GB (1985) Nutritional status: a prognostic indicator in head and neck cancer. Otolaryngol Head Neck Surg 93:69–74PubMed
30.
Zurück zum Zitat Regueiro CA, Aragón G, Millán I, Valcárcel FJ, de la Torre A, Magallón R (1994) Prognostic factors for local control, regional control and survival in oropharyngeal squamous cell carcinoma. Eur J Cancer 30:2060–2067CrossRef Regueiro CA, Aragón G, Millán I, Valcárcel FJ, de la Torre A, Magallón R (1994) Prognostic factors for local control, regional control and survival in oropharyngeal squamous cell carcinoma. Eur J Cancer 30:2060–2067CrossRef
31.
Zurück zum Zitat Hammerlid E, Wirblad B, Sandin C et al (1998) Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck 20:540–548PubMedCrossRef Hammerlid E, Wirblad B, Sandin C et al (1998) Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck 20:540–548PubMedCrossRef
32.
Zurück zum Zitat van Bokhorst-de van der Schuer MA, van Leeuwen PA et al (1999) The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer 86:519-527 van Bokhorst-de van der Schuer MA, van Leeuwen PA et al (1999) The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer 86:519-527
33.
Zurück zum Zitat Yueh B, Feinstein AR, Weaver EM, Sasaki CT, Concato J (1998) Prognostic staging system for recurrent, persistent, and second primary cancers of the oral cavity and oropharynx. Arch Otolaryngol Head Neck Surg 124:975–981PubMed Yueh B, Feinstein AR, Weaver EM, Sasaki CT, Concato J (1998) Prognostic staging system for recurrent, persistent, and second primary cancers of the oral cavity and oropharynx. Arch Otolaryngol Head Neck Surg 124:975–981PubMed
34.
Zurück zum Zitat Garavello W, Randi G, Bosetti C et al (2006) Body size and laryngeal cancer risk. Ann Oncol 17:1459–1463PubMedCrossRef Garavello W, Randi G, Bosetti C et al (2006) Body size and laryngeal cancer risk. Ann Oncol 17:1459–1463PubMedCrossRef
35.
Zurück zum Zitat Langius JA, Doornaert P, Spreeuwenberg MD et al (2010) Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer. Radiother Oncol 97:80–85PubMedCrossRef Langius JA, Doornaert P, Spreeuwenberg MD et al (2010) Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer. Radiother Oncol 97:80–85PubMedCrossRef
36.
Zurück zum Zitat van den Berg MG, Rasmussen-Conrad EL, Gwasara GM, Krabbe PF, Naber AH, Merkx MA (2006) A prospective study on weight loss and energy intake in patients with head and neck cancer, during diagnosis, treatment and revalidation. Clin Nutr 25:765–772PubMedCrossRef van den Berg MG, Rasmussen-Conrad EL, Gwasara GM, Krabbe PF, Naber AH, Merkx MA (2006) A prospective study on weight loss and energy intake in patients with head and neck cancer, during diagnosis, treatment and revalidation. Clin Nutr 25:765–772PubMedCrossRef
Metadaten
Titel
Predictors of radiotherapy outcome in patients with T2 supraglottic carcinoma
verfasst von
Tomasz Rutkowski
A. Wygoda
K. Składowski
B. Hejduk
R. Rutkowski
B. Lukaszczyk-Widel
M. Hutnik
B. Maciejewski
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 3/2012
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-011-1847-9

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