Outcomes of definitive radiotherapy vs. laryngectomy followed by adjuvant radiotherapy in patients with locally advanced laryngeal squamous cell carcinoma: real-world experience in a referral cancer center.

IF 3.3 2区医学 Q2 ONCOLOGY Radiation Oncology Pub Date : 2024-12-18 DOI:10.1186/s13014-024-02565-9

Ali Kazemian, Ebrahim Esmati, Reza Ghalehtaki, Borna Farazmand, Nima Mousavi-Darzikolaee, Reyhaneh Bayani, Mahdieh Razmkhah, Maryam Taherioun, Niloufar Saeedi, Farrokh Heidari, Kaveh Zakeri

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Abstract

Background: Laryngeal cancer is a common head and neck cancer. Surgical treatment can impair patients' voice and swallowing function, making definitive radiotherapy a viable alternative for locally advanced cases.

Methods: To compare the outcomes of definitive versus adjuvant radiotherapy in patients with primary locally advanced laryngeal cancer, we retrospectively evaluated consecutive patients treated from 2007 to 2020. We assessed and compared the median and 3-year overall survival (OS), disease-free survival (DFS), distant metastasis control (DMC), and local recurrence-free survival (LRC) in all patients and in T4 patients exclusively.

Results: One hundred patients were studied, including definitive (N = 64) and adjuvant (N = 36) radiotherapy. The median follow-up was 29 months. Overall, the median OS in the definitive vs. adjuvant group was 100 months (95%CI = 46.5-153.5) vs. not reached, respectively (log-rank P = 0.506). The median DFS in the definitive vs. adjuvant group was 20 months (95%CI = 7.7-32.3) vs. not reached, respectively (log-rank P = 0.148). Three-year OS and DFS rates in all patients were 64% (95%CI: 48-78) vs. 75% (95%CI: 55-95) and 43% (95%CI:29-57) vs. 61% (95%CI: 41-81) in the definitive vs. adjuvant groups, respectively. Among T4 patients, the median OS in the definitive RT group vs. adjuvant group was not reached vs. 48 (95%CI = 0-105.3), respectively (log-rank P = 0.788). The median DFS in the definitive RT group vs. adjuvant group was 12 months (95%CI = 9.34-14.65) vs. 36 months (95%CI = 4.4-67.5), respectively (log-rank P = 0.868). Three-year OS and DFS rates were 71% (95%CI: 42-100) vs. 75% (95%CI: 50-100) and 40% (95%CI:21-79) vs. 56% (95%CI: 25-87) in the definitive vs. adjuvant groups, respectively.

Conclusions: Our analysis suggests that definitive radiotherapy in laryngeal cancer does not lead to a poorer outcome than total laryngectomy followed by adjuvant radiotherapy. In T4 patients, our findings should reassure clinicians and patients about the viability of definitive radiotherapy as a treatment approach.

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局部晚期喉部鳞状细胞癌患者的明确放疗与喉切除术后辅助放疗的结果：转诊癌症中心的真实经验。

背景：喉癌是一种常见的头颈部肿瘤。手术治疗可能损害患者的声音和吞咽功能，使得明确的放射治疗成为局部晚期病例的可行选择。方法：为了比较原发性局部晚期喉癌患者的最终放疗与辅助放疗的结果，我们回顾性评估了2007年至2020年连续治疗的患者。我们评估并比较了所有患者和T4患者的中位和3年总生存期（OS）、无病生存期（DFS）、远处转移控制（DMC）和局部无复发生存期（LRC）。结果：100例患者，包括最终放疗（N = 64）和辅助放疗（N = 36）。中位随访时间为29个月。总体而言，最终治疗组和辅助治疗组的中位生存期分别为100个月（95%CI = 46.5-153.5）和未达到生存期（log-rank P = 0.506）。最终组和辅助组的中位DFS分别为20个月（95%CI = 7.7-32.3）和未达到（log-rank P = 0.148）。在最终组和辅助组中，所有患者的三年OS和DFS率分别为64% （95%CI: 48-78）对75% （95%CI: 55-95）和43% （95%CI:29-57）对61% （95%CI: 41-81）。在T4患者中，最终RT组与辅助组的中位OS未达到，分别为48 (95%CI = 0-105.3) （log-rank P = 0.788）。最终放疗组和辅助治疗组的中位DFS分别为12个月（95%CI = 9.34-14.65）和36个月（95%CI = 4.4-67.5）（log-rank P = 0.868）。最终组和辅助组的3年OS和DFS分别为71% （95%CI: 42-100）对75% （95%CI: 50-100）和40% （95%CI:21-79）对56% （95%CI: 25-87）。结论：我们的分析表明喉癌的最终放疗并不比全喉切除术后辅助放疗的预后差。在T4患者中，我们的研究结果应该使临床医生和患者对最终放疗作为治疗方法的可行性放心。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

6.50

自引率

2.80%

发文量

181

审稿时长

3-6 weeks

期刊介绍： Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.