| Title: |
Chemoselection as a strategy for organ preservation in patients with T4 laryngeal squamous cell carcinoma with cartilage invasion |
| Authors: |
Worden, Francis P.; Moyer, Jeffrey S.; Lee, Julia S.; Taylor, Jeremy M. G.; Urba, Susan G.; Eisbruch, Avraham; Teknos, Theodoros N.; Chepeha, Douglas B.; Prince, Mark E. P.; Hogikyan, Norman D.; Lassig, Amy Anne D.; Emerick, Kevin; Mukherji, Suresh K.; Hadjiski, Lubomir; Tsien, Christina I.; Miller, Tamara H.; Wallace, Nancy E.; Mason, Heidi L.; Bradford, Carol R.; Wolf, Gregory T. |
| Contributors: |
Department of Internal Medicine, Division of Hematology-Oncology, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.; Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.; F.P.W. and J.M. are co–first authors.; 1500 E. Medical Center Drive, C361 MIB 0848, Ann Arbor, MI 48109-0848; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.; Department of Biostatistics, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.; Department of Radiation Oncology; University of Michigan Dental School, Ann Arbor, Michigan, U.S.A.; Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A. |
| Publisher Information: |
Wiley Subscription Services, Inc., A Wiley Company |
| Publication Year: |
2009 |
| Collection: |
University of Michigan: Deep Blue |
| Subject Terms: |
Medical; Veterinary; and Health Sciences; Medicine (General); Otolaryngology; Health Sciences |
| Description: |
Objectives/Hypothesis: High rates of overall survival (OS) and laryngeal preservation were achieved in two sequential phase II clinical trials in patients with stage III/IV laryngeal squamous cell carcinoma (SCC). Patients were treated with chemoradiation after a >50% primary tumor response to one cycle of neoadjuvant chemotherapy (IC). We analyzed outcomes for T4 patients with cartilage invasion from both studies. Study Design: Retrospective. Methods: Records from 36 patients with T4 SCC of the larynx with cartilage invasion alone (n = 16) or cartilage invasion and extralaryngeal spread (n = 20) were retrospectively reviewed. All were treated with one cycle of cisplatin (100 mg/m 2 ) [or carboplatin (AUC 6)] and 5-fluorouracil (1,000 mg/m 2 /d for 5 days) (P+5FU). Those achieving >50% response at the primary tumor received chemoradiation (70 Gy; 35 fractions with concurrent cisplatin-100 mg/m 2 [carboplatin (AUC 6)] every 21 days for 3 cycles), followed by adjuvant P+5FU for complete histologic responders (CHR). Patients with 50% response following IC. Of these, 27 received definitive chemoradiation, 23 (85%) obtained CHR, with 58% laryngeal preservation rate. The 3-year OS was 78%, and the disease-specific survival was 80% (median follow-up 69 months). Following chemoradiation, 8/11 (73%) patients with an intact larynx had >75% understandable speech, 6/36 (17%) were g-tube dependent and 6/36 (17%) were tracheostomy dependent. Conclusions: Our results suggest that chemo-selection is a feasible organ preservation alternative to total laryngectomy for patients with T4 laryngeal SCC with cartilage invasion. Laryngoscope, 2009 ; Peer Reviewed ; http://deepblue.lib.umich.edu/bitstream/2027.42/63548/1/20294_ftp.pdf |
| Document Type: |
article in journal/newspaper |
| File Description: |
573924 bytes; 3118 bytes; application/pdf; text/plain |
| Language: |
unknown |
| Relation: |
https://hdl.handle.net/2027.42/63548; The Laryngoscope |
| DOI: |
10.1002/lary.20294 |
| Availability: |
https://hdl.handle.net/2027.42/63548; https://doi.org/10.1002/lary.20294 |
| Rights: |
IndexNoFollow |
| Accession Number: |
edsbas.2CC62C43 |
| Database: |
BASE |