ORGAN PRESERVATION WITH CONCURRENT CHEMORADIATION FOR ADVANCED LARYNGEAL CANCER: ARE WE SUCCEEDING?

被引:52
作者
Lambert, Louise [1 ]
Fortin, Bernard [1 ]
Soulieres, Denis [2 ]
Guertin, Louis [3 ]
Coulombe, Genevieve [1 ]
Charpentier, Danielle [2 ]
Tabet, Jean-Claude [3 ]
Belair, Manon [4 ]
Khaouam, Nader [5 ]
Nguyen-Tan, Phuc Felix [1 ]
机构
[1] Hop Notre Dame de Bon Secours, CHUM, Dept Radiat Oncol, Montreal, PQ H2L 4M1, Canada
[2] Hop Notre Dame de Bon Secours, CHUM, Dept Hematol & Oncol, Montreal, PQ H2L 4M1, Canada
[3] Hop Notre Dame de Bon Secours, CHUM, Dept Otolaryngol, Montreal, PQ H2L 4M1, Canada
[4] Hop Notre Dame de Bon Secours, CHUM, Dept Radiol, Montreal, PQ H2L 4M1, Canada
[5] Hop Maison Neuve Rosemont, Dept Radiat Oncol, Montreal, PQ H1T 2M4, Canada
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2010年 / 76卷 / 02期
关键词
Larynx; Hypopharynx; Radiotherapy; Chemotherapy; Adverse effects; Late morbidity; QUALITY-OF-LIFE; INTENSITY-MODULATED RADIOTHERAPY; NECK-CANCER; RADIATION-THERAPY; SWALLOWING DYSFUNCTION; HEAD; CHEMORADIOTHERAPY; CHEMOTHERAPY; DYSPHAGIA; CARCINOMA;
D O I
10.1016/j.ijrobp.2009.01.058
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To determine the rates of organ preservation and function in patients with advanced laryngeal and hypopharyngeal carcinomas treated with concurrent chemoradiotherapy (CRT). Methods and Materials: Between April 1999 and September 2005, 82 patients with advanced laryngeal (67%) and hypopharyngeal carcinomas (33%) underwent conventional radiotherapy and concurrent platinum-based chemotherapy with curative intent. Sixty-two patients were male (75.6%). The median age was 59 years. Eighteen patients (22%) were in Stage III and 64 (78%) were in Stage W. The median radiation dose was 70 Gy. The median potential follow-up was 3.9 years. Results: Overall survival and disease-free survival were respectively 63% and 73% at 3 years. Complete response rate from CRT was 75%. Nineteen patients (23%) experienced significant long-term toxicity after CRT: 6 (7.3%) required a percutaneous endoscopic gastrostomy, 5 (6%) had persistent Grade 2 or 3 dysphagia, 2 (2.4%) had pharyngoesophageal stenosis requiring multiple dilations, 2 (2.4%) had chronic lung aspiration, and 7 (8.5%) required a permanent tracheostomy. Four patients (4.9%) underwent laryngectomy without pathologic evidence of disease. At last follow-up, 5 (6%) patients were still dependent on a gastrostomy. Overall, 42 patients (52%) were alive, in complete response, with a functional larynx and no other major complications. Conclusions: In our institution, CRT for advanced hypopharyngeal and laryngeal carcinoma has provided good overall survival and locoregional control in the majority of patients, but a significant proportion did not benefit from this approach because of either locoregional failure or late complications. Better organ preservation approaches are necessary to improve locoregional control and to reduce long-term toxicities. (C) 2010 Elsevier Inc.
引用
收藏
页码:398 / 402
页数:5
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