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Treatment results and prognostic factors for advanced squamous cell carcinoma of the larynx treated with concurrent chemoradiotherapy

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Abstract

Objective

To review our experience with concurrent chemoradiotherapy (CCRT) for patients with advanced resectable squamous cell carcinoma (SCC) of the larynx and to evaluate the factors affecting survival and larynx preservation.

Study design

Retrospective study.

Subjects and methods

The records of 102 patients with stage III or IV resectable SCC of the larynx treated with CCRT between February 1994 and March 2009 were reviewed. Of 102 patients, 59 were treated with high-dose regimens, including cisplatin, 5-fluorouracil (5-FU), methotrexate, and leucovorin or docetaxel, cisplatin, and 5-FU, and 43 were treated with low-dose regimens, including carboplatin and uracil-tegafur or S-1. Radiotherapy was delivered 5 days a week using a single daily fraction of 1.8–2.0 Gray (Gy), to a total dose of 66.0–70.2 Gy. Overall survival (OS), disease-specific survival (DSS), and DSS with larynx preservation were estimated using Kaplan–Meier methods. The log-rank test and Cox proportional hazards regression were used to identify significant prognostic factors for DSS and DSS with larynx preservation.

Results

The 5-year OS and DSS for all patients treated with CCRT were 63.9 and 70.7 %, respectively. The 5-year DSS with larynx preservation was 54.1 %. On multivariate analysis, N stage, synchronous multiple primary cancers, and the contents of chemotherapy were significant predictors of OS for patients undergoing CCRT; T stage, N stage, and the contents of chemotherapy were significant prognostic factors for larynx preservation.

Conclusion

The treatment method including the indication for CCRT may be determined by the contents of the chemotherapy and the T and N stages of laryngeal SCC. It is important to diagnose multiple synchronous primary cancers before CCRT.

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References

  1. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer (1991) The Department of Veterans Affairs Laryngeal Cancer Study Group. N Engl J Med 324(24):1685–1690

    Google Scholar 

  2. Forastiere AA, Goepfert H, Maor M et al (2003) Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349(22):2091–2098

    Article  PubMed  CAS  Google Scholar 

  3. Katori H, Tsukuda M, Mochimatu I et al (2004) Phase I trial of concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Br J Cancer 90(2):348–352

    Article  PubMed  CAS  Google Scholar 

  4. Taguchi T, Tsukuda M, Mikami Y et al (2006) Concurrent chemoradiotherapy with cisplatin, 5-fluorouracil, methotrexate, and leucovorin in patients with advanced resectable squamous cell carcinoma of the larynx and hypopharynx. Acta Otolaryngol 126(4):408–413

    Article  PubMed  CAS  Google Scholar 

  5. Taguchi T, Ikeda Y, Mikami Y et al (2003) Combined radiotherapy and chemotherapy with carboplatin and UFT for head and neck squamous cell carcinoma. Anticancer Res 23(1B):713–717

    PubMed  CAS  Google Scholar 

  6. Tsukuda M, Ishitoya J, Mikami Y et al (2009) Analysis of feasibility and toxicity of concurrent chemoradiotherapy with S-1 for locally advanced squamous cell carcinoma of the head and neck in elderly cases and/or cases with comorbidity. Cancer Chemother Pharmacol 64(5):945–952

    Article  PubMed  Google Scholar 

  7. Pignon JP, Bourhis J, Domenge C, Designe L (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 355(9208):949–955

    PubMed  CAS  Google Scholar 

  8. Seiwert TY, Cohen EE (2005) State-of-the-art management of locally advanced head and neck cancer. Br J Cancer 92(8):1341–1348

    Article  PubMed  CAS  Google Scholar 

  9. Forastiere AA, Zhang Q, Weber RS et al (2013) Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 31(7):845–852

    Article  PubMed  CAS  Google Scholar 

  10. Jeremic B, Milicic B (2009) Pretreatment prognostic factors of survival in patients with locally advanced nonmetastatic squamous cell carcinoma of the head and neck treated with radiation therapy with or without concurrent chemotherapy. Am J Clin Oncol 32(2):163–168

    Article  PubMed  Google Scholar 

  11. Lodder WL, Pameijer FA, Rasch CR, van den Brekel MW, Balm AJ (2012) Prognostic significance of radiologically determined neck node volume in head and neck cancer: a systematic review. Oral Oncol 48(4):298–302

    Article  PubMed  CAS  Google Scholar 

  12. Jakobsen J, Hansen O, Jorgensen KE, Bastholt L (1998) Lymph node metastases from laryngeal and pharyngeal carcinomas–calculation of burden of metastasis and its impact on prognosis. Acta Oncol 37(5):489–493

    Article  PubMed  CAS  Google Scholar 

  13. Suntharalingam M, Haas ML, Van Echo DA et al (2001) Predictors of response and survival after concurrent chemotherapy and radiation for locally advanced squamous cell carcinomas of the head and neck. Cancer 91(3):548–554

    Article  PubMed  CAS  Google Scholar 

  14. Douple EB, Richmond RC, O’Hara JA, Coughlin CT (1985) Carboplatin as a potentiator of radiation therapy. Cancer Treat Rev 12(suppl A):111–124

    Article  PubMed  CAS  Google Scholar 

  15. Colevas AD, Posner MR (1998) Docetaxel in head and neck cancer: a review. Am J Clin Oncol 21(5):482–486

    Article  PubMed  CAS  Google Scholar 

  16. Fu KK, Phillips TL (1991) Biologic rationale of combined radiotherapy and chemotherapy. In: Hematol Oncol Clin North Am :737–751

  17. Smalley SR, Kimler BF, Evans RG (1991) 5-Fluorouracil modulation of radiosensitivity in cultured human carcinoma cells. Int J Radiat Oncol Biol Phys 20(2):207–211

    Article  PubMed  CAS  Google Scholar 

  18. Esposito ED, Bevilacqua L, Guadagno MT (2000) Multiple primary malignant neoplasm in patients with laryngeal carcinoma. J Surg Oncol 74(1):83–86

    Article  PubMed  CAS  Google Scholar 

  19. Nikolaou AC, Markou CD, Petridis DG, Daniilidis IC (2000) Second primary neoplasms in patients with laryngeal carcinoma. Laryngoscope 110(1):58–64

    Article  PubMed  CAS  Google Scholar 

  20. Yabuki K, Kubota A, Horiuchi C, Taguchi T, Nishimura G, Inamori M (2013) Limitations of PET and PET/CT in detecting upper gastrointestinal synchronous cancer in patients with head and neck carcinoma. Eur Arch Otorhinolaryngol 270(2):727–733

    Article  PubMed  Google Scholar 

  21. Ikeda Y, Tsukuda M, Ishitoya J et al (2005) Four cases of simultaneous triple primary cancers of the hypopharynx, esophagus, and stomach. Otolaryngol Head Neck Surg 132(5):788–793

    Article  PubMed  Google Scholar 

  22. Brockstein B, Haraf DJ, Rademaker AW et al (2004) Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: a 9-year, 337-patient, multi-institutional experience. Ann Oncol 15(8):1179–1186

    Article  PubMed  CAS  Google Scholar 

  23. Knegjens JL, Hauptmann M, Pameijer FA et al (2011) Tumor volume as prognostic factor in chemoradiation for advanced head and neck cancer. Head Neck 33(3):375–382

    PubMed  Google Scholar 

  24. Stenson KM, Maccracken E, Kunnavakkam R et al (2012) Chemoradiation for patients with large-volume laryngeal cancers. Head Neck 34(8):1162–1167

    Article  PubMed  Google Scholar 

  25. Knab BR, Salama JK, Solanki A et al (2008) Functional organ preservation with definitive chemoradiotherapy for T4 laryngeal squamous cell carcinoma. Ann Oncol 19(9):1650–1654

    Article  PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Takahide Taguchi, Goshi Nishimura, Masahiro Takahashi, Masanori Komatsu, Daisuke Sano, Naoko Sakuma, Yasuhiro Arai & Nobuhiko Oridate

  2. Department of Otorhinolaryngology, Medical Center, Yokohama City University, Yokohama, Japan

    Yukiko Yamashita, Osamu Shiono, Mariko Hirama, Yasunori Sakuma & Jun-ichi Ishitoya

  3. Department of Radiology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Masaharu Hata

  4. Department of Radiology, Medical Center, Yokohama City University, Yokohama, Japan

    Ichiro Ogino

Authors
  1. Takahide Taguchi
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  2. Goshi Nishimura
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  3. Masahiro Takahashi
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  4. Masanori Komatsu
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  5. Daisuke Sano
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  6. Naoko Sakuma
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  7. Yasuhiro Arai
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  8. Yukiko Yamashita
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  9. Osamu Shiono
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  10. Mariko Hirama
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  11. Yasunori Sakuma
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  12. Jun-ichi Ishitoya
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  13. Masaharu Hata
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  14. Ichiro Ogino
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  15. Nobuhiko Oridate
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Corresponding author

Correspondence to Takahide Taguchi.

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Taguchi, T., Nishimura, G., Takahashi, M. et al. Treatment results and prognostic factors for advanced squamous cell carcinoma of the larynx treated with concurrent chemoradiotherapy. Cancer Chemother Pharmacol 72, 837–843 (2013). https://doi.org/10.1007/s00280-013-2261-3

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  • DOI: https://doi.org/10.1007/s00280-013-2261-3

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