OBJECTIVES To evaluate the prognostic factors and the treatment results in early stage glottic laryngeal carcinoma patients treated with radiation therapy. METHODS The records of 83 patients (80 males; 3 females; mean age 62 years; range 40 to 85 years) treated with radical radiotherapy at Ege University Medical School Department of Radiation Oncology during January 1995-December 2004 were studied retrospectively. RESULTS Twenty-nine patients had (34.9%) T1a, 29 patients had (34.9%) T1b and 25 patients had (30.1%) T2 stage disease. During a median follow-up of 56 months, 13 patients had failures. Five year local control rates were 90.5% in T1 and 73.2% in T2 patients. Locoregional control rates were 89% in T1 and 70.5% in T2 patients. Treatment interruption more than 5 days was noted as a prognostic factor affecting local and locoregional control. Five year disease specific survival rates were 94% in T1 and 79% in T2 patients, T stage and radiotherapy interruption more than 5 days were noted as prognostic factors affecting disease specific survival. CONCLUSION Curative radiotherapy is an effective treatment modality in early stage glottic laryngeal cancer.
1. Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB. Management of T1-T2 glottic carcinomas. Cancer 2004;100(9):1786-92.
2. Rosier JF, Gregoire V, Counoy H, Octave-Prignot M, Rombaut P, Scalliet P, et al. Comparison of external radiotherapy, laser microsurgery and partial laryngectomy for the treatment of T1N0M0 glottic carcinomas: a retrospective evaluation. Radiother Oncol 1998;48(2):175-83.
3. Stewart MG, Chen AY, Stach CB. Outcomes analysis of voice and quality of life in patients with laryngeal c a n c e r. Arch Otolaryngol Head Neck Surg 1998;124(2):143-8.
4. Verdonck-de Leeuw IM, Hilgers FJ, Keus RB, Koopmans-van Beinum FJ, Greven AJ, de Jong JM, et al. Multidimensional assessment of voice characteristics after radiotherapy for early glottic cancer. Laryngoscope 1999;109(2 Pt 1):241-8.
5. Sewnaik A, Meeuwis CA, van der Kwast TH, Kerrebijn JD. Partial laryngectomy for recurrent glottic carcinoma after radiotherapy. Head Neck 2005;27(2):101-7.
6. Mendenhall WM, Amdur RJ, Morris CG, Hinerman RW. T1-T2N0 squamous cell carcinoma of the glottic larynx treated with radiation therapy. J Clin Oncol 2001;19(20):4029-36.
7. Le QT, Fu KK, Kroll S, Ryu JK, Quivey JM, Meyler TS, et al. Influence of fraction size, total dose, and overall time on local control of T1-T2 glottic carcinoma. Int J Radiat Oncol Biol Phys 1997;39(1):115-26.
8. Warde P, O'Sullivan B, Bristow RG, Panzarella T, Keane TJ, Gullane PJ, et al. T1/T2 glottic cancer managed by external beam radiotherapy: the influence of pretreatment hemoglobin on local control. Int J Radiat Oncol Biol Phys 1998;41(2):347-53.
9. Garden AS, Forster K, Wong PF, Morrison WH, Schechter NR, Ang KK. Results of radiotherapy for T2N0 glottic carcinoma: does the "2" stand for twicedaily treatment? Int J Radiat Oncol Biol Phys 2003;55(2):322-8.
10. Demiral AN, Sarioglu S, Birlik B, Sen M, Kinay M. Prognostic significance of EGF receptor expression in early glottic cancer. Auris Nasus Larynx 2004;31(4):417-24.
11. Nix P, Cawkwell L, Patmore H, Greenman J, Stafford N. Bcl-2 expression predicts radiotherapy failure in laryngeal cancer. Br J Cancer 2005;92(12):2185-9.
12. AJCC Cancer Staging Manual. 6th ed. New York: Springer-Verlag; 2002. Chap. 5.
13. Franchin G, Minatel E, Gobitti C, Talamini R, Sartor G, Caruso G, et al. Radiation treatment of glottic squamous cell carcinoma, stage I and II: analysis of factors affecting prognosis. Int J Radiat Oncol Biol Phys 1998;40(3):541-8.
14. Marshak G, Brenner B, Shvero J, Shapira J, Ophir D, Hochman I, et al. Prognostic factors for local control of early glottic cancer: the Rabin Medical Center retrospective study on 207 patients. Int J Radiat Oncol Biol Phys 1999;43(5):1009-13.
15. Mendenhall WM, Hinerman RW, Amdur RJ, Mancusco AA, Villaret DB, Robbins KT. Larynx. In: Perez CA, Brady LW, Halperin EC, Schmidt-Ullrich RK, editors. Principles and Practice of Radiation O n c o l o g y. 4th ed. Philadelphia, USA: Lippincott Williams&Wilkins; 2004. p. 1094-116.
16.Carl J, Andersen LJ, Pedersen M, Greisen O. Prognostic factors of local control after radiotherapy in T1 glottic and supraglottic carcinoma of the larynx. Radiother Oncol 1996;39(3):229-33.
17. Fernberg JO, Ringborg U, Silfversward C, Ewert G, Haglund S, Schiratzki H, et al. Radiation therapy in early glottic cancer. Analysis of 177 consecutive cases. Acta Otolaryngol 1989;108(5-6):478-81.
18. Groome PA, O’Sullivan B, Mackillop WJ, Jackson LD, Schulze K, Irish JC, Warde PR, et al. Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules. Int J Radiat Oncol Biol Phys 2006;64(4):1002-12.
19.Chen MF, Chang JT, Tsang NM, Liao CT, Chen WC. Radiotherapy of early-stage glottic cancer: analysis of factors affecting prognosis. Ann Otol Rhinol Laryngol 2003;112(10):904-11.
20. Murakami R, Nishimura R, Baba Y, Furusawa M, Ogata N, Yumoto E, et al. Prognostic factors of glottic carcinomas treated with radiation therapy: value of the adjacent sign on radiological examinations in the sixth edition of the UICC TNM staging system. Int J Radiat Oncol Biol Phys 2005;61(2):471-5.
21. Zouhair A, Azria D, Coucke P, Matzinger O, Bron L, Moeckli R, et al. Decreased local control following radiation therapy alone in early-stage glottic carcinoma with anterior commissure extension. Strahlenther Onkol 2004;180(2):84-90.
22. Fowler JF, Lindstrom MJ. Loss of local control with prolongation in radiotherapy. Int J Radiat Oncol Biol Phys 1992;23(2):457-67.
23. Overgaard J, Alsner J, Eriksen J, Horsman MR, Grau C. Importance of overall treatment time for the response to radiotherapy in patients with squamous cell carcinoma of the head and neck. Rays 2000;25(3):313-9.
24. Mercante G, Bacciu A, Banchini L, Moretto E, Oretti G, Ferri T. Salvage surgery after radiation failure in squamous cell carcinoma of the larynx. B-ENT 2005;1(3):107-11.
25.Cooper JS, Pajak TF, Rubin P, Tupchong L, Brady LW, Leibel SA, et al. Second malignancies in patients who have head and neck cancer: incidence, effect on survival and implications based on the RTOG experience. Int J Radiat Oncol Biol Phys 1989;17(3):449-56.
26. Fujita M, Rudoltz MS, Canady DJ, Patel P, Machtay M, Pittard MQ, et al. Second malignant neoplasia in patients with T1 glottic cancer treated with radiation. Laryngoscope 1998;108(12):1853-5.
27. McDonald S, Haie C, Rubin P, Nelson D, Divers LD. Second malignant tumors in patients with laryngeal carcinoma: diagnosis, treatment, and prevention. Int J Radiat Oncol Biol Phys 1989;17(3):457-65.
28. Gluckman JL, Crissman JD. Survival rates in 548 patients with multiple neoplasms of the upper aerodigestive tract. Laryngoscope 1983;93(1):71-4.
29. Holland JM, Arsanjani A, Liem BJ, Hoffelt SC, Cohen JI, Stevens KR Jr. Second malignancies in early stage laryngeal carcinoma patients treated with radiotherapy. J Laryngol Otol 2002;116(3):190-3.
30.Johansen LV, Grau C, Overgaard J. Glottic carcinoma- -patterns of failure and salvage treatment after curative radiotherapy in 861 consecutive patients. Radiother Oncol 2002 Jun;63(3):257-67.
31. McLaughlin MP, Parsons JT, Fein DA, Stringer SP, Cassisi NJ, Mendenhall WM, et al. Salvage surgery after radiotherapy failure in T1-T2 squamous cell carcinoma of the glottic larynx. Head Neck 1996;18(3):229-35.
32. Marchese-Ragona R, Marioni G, Chiarello G, Staffieri A, Pastore A. Supracricoid laryngectomy with cricohyoidopexy for recurrence of early-stage glottic carcinoma after irradiation. Long-term oncological and functional results. Acta Otolaryngol 2005;125(1):91- 5.
33. Stalpers LJ, Verbeek AL, van Daal WA. Results of radiotherapy and surgery for glottic carcinoma. Cancer Treat Rev 1987;14(2):131-41.
34. Frata P, Cellai E, Magrini SM, Bonetti B, Vitali E, Tonoli S, et al. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. II. The case of T2N0 disease. Int J Radiat Oncol Biol Phys 2005;63(5):1387-94.
35.Cellai E, Frata P, Magrini SM, Paiar F, Barca R, Fondelli S, et al. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. I. The case of T1N0 disease. Int J Radiat Oncol Biol Phys 2005;63(5):1378-86.
Erken evre glottik larenks kanserlerinde küratif radyoterapi
Year 2006,
Volume: 21 Issue: 1, 28 - 36, 01.02.2006
AMAÇ Küratif radyoterapi uygulanan erken evre glottik larenks kanserli olgularda tedavi sonuçları ve prognostik faktörlerin değerlendirilmesidir. GEREÇ VE YÖNTEM 1995-2004 yılları arasında Ege Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalında, küratif radyoterapi uygulanan 83 hasta (80 erkek; 3 kadın; ort. yaş 62; dağılım 40-85) geriye dönük olarak değerlendirildi. BULGULAR Değerlendirmeye alınan 83 olgunun 29'u (%34.9) T1a, 29'u (%34.9) T1b, 25'i (%30.1) T2 evresinde idi. Ortalama 56 aylık takipte toplam 13 olguda yineleme görüldü. Beş yıllık lokal kontrol oranları T1 olgularda %90.5, T2 olgularda %73.2, lokal bölgesel kontrol oranları ise T1 olgularda %89, T2 olgularda %70.5 idi. Radyoterapiye beş günden fazla ara verilmesi lokal, lokal-bölgesel kontrolü etkileyen prognostik faktör olarak saptandı. Beş yıllık hastalığa özgü sağkalım oranları; T1 olgularda %94, T2 olgularda %79 olarak belirlendi; T evresi ve radyoterapiye beş günden fazla ara verilmesi hastalığa özgü sağkalımı etkileyen prognostik faktörler olarak saptandı. SONUÇ Erken evre glottik larenks kanserlerinde, tek başına küratif radyoterapi, etkin bir tedavi modelidir.
1. Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB. Management of T1-T2 glottic carcinomas. Cancer 2004;100(9):1786-92.
2. Rosier JF, Gregoire V, Counoy H, Octave-Prignot M, Rombaut P, Scalliet P, et al. Comparison of external radiotherapy, laser microsurgery and partial laryngectomy for the treatment of T1N0M0 glottic carcinomas: a retrospective evaluation. Radiother Oncol 1998;48(2):175-83.
3. Stewart MG, Chen AY, Stach CB. Outcomes analysis of voice and quality of life in patients with laryngeal c a n c e r. Arch Otolaryngol Head Neck Surg 1998;124(2):143-8.
4. Verdonck-de Leeuw IM, Hilgers FJ, Keus RB, Koopmans-van Beinum FJ, Greven AJ, de Jong JM, et al. Multidimensional assessment of voice characteristics after radiotherapy for early glottic cancer. Laryngoscope 1999;109(2 Pt 1):241-8.
5. Sewnaik A, Meeuwis CA, van der Kwast TH, Kerrebijn JD. Partial laryngectomy for recurrent glottic carcinoma after radiotherapy. Head Neck 2005;27(2):101-7.
6. Mendenhall WM, Amdur RJ, Morris CG, Hinerman RW. T1-T2N0 squamous cell carcinoma of the glottic larynx treated with radiation therapy. J Clin Oncol 2001;19(20):4029-36.
7. Le QT, Fu KK, Kroll S, Ryu JK, Quivey JM, Meyler TS, et al. Influence of fraction size, total dose, and overall time on local control of T1-T2 glottic carcinoma. Int J Radiat Oncol Biol Phys 1997;39(1):115-26.
8. Warde P, O'Sullivan B, Bristow RG, Panzarella T, Keane TJ, Gullane PJ, et al. T1/T2 glottic cancer managed by external beam radiotherapy: the influence of pretreatment hemoglobin on local control. Int J Radiat Oncol Biol Phys 1998;41(2):347-53.
9. Garden AS, Forster K, Wong PF, Morrison WH, Schechter NR, Ang KK. Results of radiotherapy for T2N0 glottic carcinoma: does the "2" stand for twicedaily treatment? Int J Radiat Oncol Biol Phys 2003;55(2):322-8.
10. Demiral AN, Sarioglu S, Birlik B, Sen M, Kinay M. Prognostic significance of EGF receptor expression in early glottic cancer. Auris Nasus Larynx 2004;31(4):417-24.
11. Nix P, Cawkwell L, Patmore H, Greenman J, Stafford N. Bcl-2 expression predicts radiotherapy failure in laryngeal cancer. Br J Cancer 2005;92(12):2185-9.
12. AJCC Cancer Staging Manual. 6th ed. New York: Springer-Verlag; 2002. Chap. 5.
13. Franchin G, Minatel E, Gobitti C, Talamini R, Sartor G, Caruso G, et al. Radiation treatment of glottic squamous cell carcinoma, stage I and II: analysis of factors affecting prognosis. Int J Radiat Oncol Biol Phys 1998;40(3):541-8.
14. Marshak G, Brenner B, Shvero J, Shapira J, Ophir D, Hochman I, et al. Prognostic factors for local control of early glottic cancer: the Rabin Medical Center retrospective study on 207 patients. Int J Radiat Oncol Biol Phys 1999;43(5):1009-13.
15. Mendenhall WM, Hinerman RW, Amdur RJ, Mancusco AA, Villaret DB, Robbins KT. Larynx. In: Perez CA, Brady LW, Halperin EC, Schmidt-Ullrich RK, editors. Principles and Practice of Radiation O n c o l o g y. 4th ed. Philadelphia, USA: Lippincott Williams&Wilkins; 2004. p. 1094-116.
16.Carl J, Andersen LJ, Pedersen M, Greisen O. Prognostic factors of local control after radiotherapy in T1 glottic and supraglottic carcinoma of the larynx. Radiother Oncol 1996;39(3):229-33.
17. Fernberg JO, Ringborg U, Silfversward C, Ewert G, Haglund S, Schiratzki H, et al. Radiation therapy in early glottic cancer. Analysis of 177 consecutive cases. Acta Otolaryngol 1989;108(5-6):478-81.
18. Groome PA, O’Sullivan B, Mackillop WJ, Jackson LD, Schulze K, Irish JC, Warde PR, et al. Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules. Int J Radiat Oncol Biol Phys 2006;64(4):1002-12.
19.Chen MF, Chang JT, Tsang NM, Liao CT, Chen WC. Radiotherapy of early-stage glottic cancer: analysis of factors affecting prognosis. Ann Otol Rhinol Laryngol 2003;112(10):904-11.
20. Murakami R, Nishimura R, Baba Y, Furusawa M, Ogata N, Yumoto E, et al. Prognostic factors of glottic carcinomas treated with radiation therapy: value of the adjacent sign on radiological examinations in the sixth edition of the UICC TNM staging system. Int J Radiat Oncol Biol Phys 2005;61(2):471-5.
21. Zouhair A, Azria D, Coucke P, Matzinger O, Bron L, Moeckli R, et al. Decreased local control following radiation therapy alone in early-stage glottic carcinoma with anterior commissure extension. Strahlenther Onkol 2004;180(2):84-90.
22. Fowler JF, Lindstrom MJ. Loss of local control with prolongation in radiotherapy. Int J Radiat Oncol Biol Phys 1992;23(2):457-67.
23. Overgaard J, Alsner J, Eriksen J, Horsman MR, Grau C. Importance of overall treatment time for the response to radiotherapy in patients with squamous cell carcinoma of the head and neck. Rays 2000;25(3):313-9.
24. Mercante G, Bacciu A, Banchini L, Moretto E, Oretti G, Ferri T. Salvage surgery after radiation failure in squamous cell carcinoma of the larynx. B-ENT 2005;1(3):107-11.
25.Cooper JS, Pajak TF, Rubin P, Tupchong L, Brady LW, Leibel SA, et al. Second malignancies in patients who have head and neck cancer: incidence, effect on survival and implications based on the RTOG experience. Int J Radiat Oncol Biol Phys 1989;17(3):449-56.
26. Fujita M, Rudoltz MS, Canady DJ, Patel P, Machtay M, Pittard MQ, et al. Second malignant neoplasia in patients with T1 glottic cancer treated with radiation. Laryngoscope 1998;108(12):1853-5.
27. McDonald S, Haie C, Rubin P, Nelson D, Divers LD. Second malignant tumors in patients with laryngeal carcinoma: diagnosis, treatment, and prevention. Int J Radiat Oncol Biol Phys 1989;17(3):457-65.
28. Gluckman JL, Crissman JD. Survival rates in 548 patients with multiple neoplasms of the upper aerodigestive tract. Laryngoscope 1983;93(1):71-4.
29. Holland JM, Arsanjani A, Liem BJ, Hoffelt SC, Cohen JI, Stevens KR Jr. Second malignancies in early stage laryngeal carcinoma patients treated with radiotherapy. J Laryngol Otol 2002;116(3):190-3.
30.Johansen LV, Grau C, Overgaard J. Glottic carcinoma- -patterns of failure and salvage treatment after curative radiotherapy in 861 consecutive patients. Radiother Oncol 2002 Jun;63(3):257-67.
31. McLaughlin MP, Parsons JT, Fein DA, Stringer SP, Cassisi NJ, Mendenhall WM, et al. Salvage surgery after radiotherapy failure in T1-T2 squamous cell carcinoma of the glottic larynx. Head Neck 1996;18(3):229-35.
32. Marchese-Ragona R, Marioni G, Chiarello G, Staffieri A, Pastore A. Supracricoid laryngectomy with cricohyoidopexy for recurrence of early-stage glottic carcinoma after irradiation. Long-term oncological and functional results. Acta Otolaryngol 2005;125(1):91- 5.
33. Stalpers LJ, Verbeek AL, van Daal WA. Results of radiotherapy and surgery for glottic carcinoma. Cancer Treat Rev 1987;14(2):131-41.
34. Frata P, Cellai E, Magrini SM, Bonetti B, Vitali E, Tonoli S, et al. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. II. The case of T2N0 disease. Int J Radiat Oncol Biol Phys 2005;63(5):1387-94.
35.Cellai E, Frata P, Magrini SM, Paiar F, Barca R, Fondelli S, et al. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. I. The case of T1N0 disease. Int J Radiat Oncol Biol Phys 2005;63(5):1378-86.
Esassolak, M., Dubova, S., Kamer, S., Aydın, B. (2006). Erken evre glottik larenks kanserlerinde küratif radyoterapi. Türk Onkoloji Dergisi, 21(1), 28-36.
AMA
Esassolak M, Dubova S, Kamer S, Aydın B. Erken evre glottik larenks kanserlerinde küratif radyoterapi. Türk Onkoloji Dergisi. February 2006;21(1):28-36.
Chicago
Esassolak, Mustafa, Senem Dubova, Serra Kamer, and Barbaros Aydın. “Erken Evre Glottik Larenks Kanserlerinde küratif Radyoterapi”. Türk Onkoloji Dergisi 21, no. 1 (February 2006): 28-36.
EndNote
Esassolak M, Dubova S, Kamer S, Aydın B (February 1, 2006) Erken evre glottik larenks kanserlerinde küratif radyoterapi. Türk Onkoloji Dergisi 21 1 28–36.
IEEE
M. Esassolak, S. Dubova, S. Kamer, and B. Aydın, “Erken evre glottik larenks kanserlerinde küratif radyoterapi”, Türk Onkoloji Dergisi, vol. 21, no. 1, pp. 28–36, 2006.
ISNAD
Esassolak, Mustafa et al. “Erken Evre Glottik Larenks Kanserlerinde küratif Radyoterapi”. Türk Onkoloji Dergisi 21/1 (February 2006), 28-36.
JAMA
Esassolak M, Dubova S, Kamer S, Aydın B. Erken evre glottik larenks kanserlerinde küratif radyoterapi. Türk Onkoloji Dergisi. 2006;21:28–36.
MLA
Esassolak, Mustafa et al. “Erken Evre Glottik Larenks Kanserlerinde küratif Radyoterapi”. Türk Onkoloji Dergisi, vol. 21, no. 1, 2006, pp. 28-36.
Vancouver
Esassolak M, Dubova S, Kamer S, Aydın B. Erken evre glottik larenks kanserlerinde küratif radyoterapi. Türk Onkoloji Dergisi. 2006;21(1):28-36.