Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival
Abstract Objectives To evaluate the outcomes of advanced‐stage laryngeal squamous cell carcinoma (SCC) patients treated with functional‐preservation strategy with a specific focus on laryngo‐esophageal dysfunction disease‐free survival (LEDDFS). Methods and materials A retrospective review was condu...
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Laryngoscope Investigative Otolaryngology |
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| Online Access: | https://doi.org/10.1002/lio2.972 |
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| author | Issa Mohamad Abdelatif Almousa Ayat Taqash Ebrahim Mayta Fawzi Abuhijla Hamza Ghatasheh Hazem Ababneh Lina Wahbeh Ramiz Abuhijlih Tariq Hussein Wisam Al‐Gargaz Ali Hosni |
| author_facet | Issa Mohamad Abdelatif Almousa Ayat Taqash Ebrahim Mayta Fawzi Abuhijla Hamza Ghatasheh Hazem Ababneh Lina Wahbeh Ramiz Abuhijlih Tariq Hussein Wisam Al‐Gargaz Ali Hosni |
| author_sort | Issa Mohamad |
| collection | DOAJ |
| description | Abstract Objectives To evaluate the outcomes of advanced‐stage laryngeal squamous cell carcinoma (SCC) patients treated with functional‐preservation strategy with a specific focus on laryngo‐esophageal dysfunction disease‐free survival (LEDDFS). Methods and materials A retrospective review was conducted of stage III‐IVB laryngeal SCC patients who were treated with curative‐intent radiotherapy (RT) (2007–2018). Patients were preferentially managed with upfront chemoradiation (CCRT); except for those with cN2‐3, cT4, or large volume cT3 (induction chemotherapy followed by RT or CCRT is an option), and those who were unfit or declined chemotherapy (received altered RT). The primary endpoint was 3‐year LEDDFS, and secondary endpoints were 3‐year local failure (LF), regional failure (RF), distant metastasis (DM), overall survival (OS), disease‐free survival (DFS), and acute and late toxicities. Cox proportional hazard tests were used for multivariable analysis (MVA). Results A total of 213 cases were included. With a median follow‐up of 37 months, the 3‐year LEDDFS was 50%, while the 3‐year OS, DFS, LF, RF, and DM were 81%, 74%, 9%, 5%, and 7%, respectively. On MVA, cT4‐category was the only predictor of inferior LEDDFS (HR: 0.47, [95% CI: 0.29–0.74], p < .01). The most common grade ≥ 3 acute and late radiation therapy oncology group (RTOG) toxicity were esophageal toxicity: 16.7% and 29.6%, respectively. Conclusions Primary RT resulted in favorable oncologic and functional outcomes in only half of the advanced‐stage laryngeal cancer patients. Future clinical trials are required to investigate further treatment options aiming to improve the oncologic and maintain functional outcomes with utilization of LEDDFS as the primary endpoint. Level of evidence 4. |
| format | Article |
| id | doaj-art-bbd6120b166344f5b7ee29748498dcec |
| institution | OA Journals |
| issn | 2378-8038 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj-art-bbd6120b166344f5b7ee29748498dcec2025-08-20T01:48:03ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-12-01761866187410.1002/lio2.972Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survivalIssa Mohamad0Abdelatif Almousa1Ayat Taqash2Ebrahim Mayta3Fawzi Abuhijla4Hamza Ghatasheh5Hazem Ababneh6Lina Wahbeh7Ramiz Abuhijlih8Tariq Hussein9Wisam Al‐Gargaz10Ali Hosni11Department of Radiation Oncology King Hussein Cancer Center Amman JordanDepartment of Radiation Oncology King Hussein Cancer Center Amman JordanDepartment of Biostatistics King Hussein Cancer Center Amman JordanDepartment of Surgical Oncology King Hussein Cancer Center Amman JordanDepartment of Radiation Oncology King Hussein Cancer Center Amman JordanDepartment of Radiation Oncology King Hussein Cancer Center Amman JordanDepartment of Radiation Oncology Massachusetts General Hospital Boston Massachusetts USADepartment of Radiation Oncology King Hussein Cancer Center Amman JordanDepartment of Radiation Oncology King Hussein Cancer Center Amman JordanDepartment of Radiation Oncology King Hussein Cancer Center Amman JordanDepartment of Surgical Oncology King Hussein Cancer Center Amman JordanRadiation Medicine Program, Princess Margaret Cancer Centre University Health Network, University of Toronto Toronto Ontario CanadaAbstract Objectives To evaluate the outcomes of advanced‐stage laryngeal squamous cell carcinoma (SCC) patients treated with functional‐preservation strategy with a specific focus on laryngo‐esophageal dysfunction disease‐free survival (LEDDFS). Methods and materials A retrospective review was conducted of stage III‐IVB laryngeal SCC patients who were treated with curative‐intent radiotherapy (RT) (2007–2018). Patients were preferentially managed with upfront chemoradiation (CCRT); except for those with cN2‐3, cT4, or large volume cT3 (induction chemotherapy followed by RT or CCRT is an option), and those who were unfit or declined chemotherapy (received altered RT). The primary endpoint was 3‐year LEDDFS, and secondary endpoints were 3‐year local failure (LF), regional failure (RF), distant metastasis (DM), overall survival (OS), disease‐free survival (DFS), and acute and late toxicities. Cox proportional hazard tests were used for multivariable analysis (MVA). Results A total of 213 cases were included. With a median follow‐up of 37 months, the 3‐year LEDDFS was 50%, while the 3‐year OS, DFS, LF, RF, and DM were 81%, 74%, 9%, 5%, and 7%, respectively. On MVA, cT4‐category was the only predictor of inferior LEDDFS (HR: 0.47, [95% CI: 0.29–0.74], p < .01). The most common grade ≥ 3 acute and late radiation therapy oncology group (RTOG) toxicity were esophageal toxicity: 16.7% and 29.6%, respectively. Conclusions Primary RT resulted in favorable oncologic and functional outcomes in only half of the advanced‐stage laryngeal cancer patients. Future clinical trials are required to investigate further treatment options aiming to improve the oncologic and maintain functional outcomes with utilization of LEDDFS as the primary endpoint. Level of evidence 4.https://doi.org/10.1002/lio2.972cancerlaryngeallaryngo‐esophageal dysfunctionorgan preservationoutcomesradiation |
| spellingShingle | Issa Mohamad Abdelatif Almousa Ayat Taqash Ebrahim Mayta Fawzi Abuhijla Hamza Ghatasheh Hazem Ababneh Lina Wahbeh Ramiz Abuhijlih Tariq Hussein Wisam Al‐Gargaz Ali Hosni Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival Laryngoscope Investigative Otolaryngology cancer laryngeal laryngo‐esophageal dysfunction organ preservation outcomes radiation |
| title | Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival |
| title_full | Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival |
| title_fullStr | Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival |
| title_full_unstemmed | Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival |
| title_short | Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival |
| title_sort | primary radiation therapy for advanced stage laryngeal cancer a laryngo esophageal dysfunction disease free survival |
| topic | cancer laryngeal laryngo‐esophageal dysfunction organ preservation outcomes radiation |
| url | https://doi.org/10.1002/lio2.972 |
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