Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Paper

Impact of Previous Tracheotomy as a Prognostic Factor in Patients with Locally Advanced Squamous Cell Carcinoma of the Larynx Submitted to Concomitant Chemotherapy and Radiation

Herchenhorn D.a · Dias F.L.b · Ferreira C.G.c · Araújo C.M.d · Lima R.A.b · Small I.A.c · Kligerman J.b

Author affiliations

Departments of aClinical Oncology, bHead and Neck Surgery, cClinical Research and dRadiation Therapy, Instituto Nacional de Câncer, Rio de Janeiro, Brazil

Related Articles for ""

ORL 2008;70:381–388

Do you have an account?

Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: October 02, 2007
Accepted: March 11, 2008
Published online: November 04, 2008
Issue release date: November 2008

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 6

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL

Abstract

Hypothesis: The combination of chemotherapy and radiotherapy is a standard nonsurgical treatment for locally advanced laryngeal cancer. Nevertheless, there are no validated markers to predict the outcome of nonsurgical therapies. The impact of previous tracheotomy is not clear in patients submitted to concomitant chemoradiotherapy. Study Design: A non-randomized prospective study. Prognostic factors such as stage, age, performance status, number of chemotherapy cycles, radiotherapy dose, stage VIb disease, and previous tracheotomy were analyzed using the Cox’s proportional hazard model. The Kaplan-Meier and log rank tests were used to evaluate the progression-free and overall survival. Patients and Methods: Patients with stage III/IV laryngeal carcinoma were prospectively selected. Treatment consisted of cisplatin 100 mg/m2 every 3 weeks for 3 cycles, radiotherapy to a total dose of 70.2 Gy and salvage surgery. Results: Forty-nine patients were analyzed; tracheotomy was performed in 12 patients (24.5%) before therapy. Patients who had previous tracheotomy had a lower rate of complete response (41.7 vs. 75%, p = 0.034, HR 0.55, CI 95% 0.27–1.11), shorter progression free-survival (HR 2.83, CI 95% 1.60–4.88, p < 0.001), and median overall survival (12 vs. 56 months, HR 2.37, CI 95% 1.43–3.93, p < 0.001), in comparison to those without a tracheotomy. Moreover a significant difference was observed in 3-year survival rates (6 vs. 61%, p = 0.001), in favor of the group without tracheotomy. Interestingly, the impact of previous tracheotomy was not altered when adjusted by other prognostic factors (HR 8.7, CI 95% 3.1–24.0, p < 0.001). Conclusions: Previous tracheotomy is a negative prognostic factor for patients submitted to chemotherapy combined with radiotherapy and should be considered as a negative clinical prognostic factor in the selection of patients for more aggressive treatment strategies.

© 2008 S. Karger AG, Basel


References

  1. Jemal A, Tiwari RC, Murray T, et al: Cancer statistics, 2004. CA Cancer J Clin 2004;54:8–29.
  2. Ministério da Saúde: Instituto Nacional de Câncer. Estimativas da incidência e mortalidade por câncer no Brasil. Rio de Janeiro. INCA 2003;92. www.inca.gov.br, accessed March 10, 2007.
  3. Pignon JP, Bourhis J, Domenge C, Designé L: Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 2000;355:949–955.
  4. El-Sayed S, Nelson N: Adjuvant and adjunctive chemotherapy in the management of squamous cell carcinoma of the head and neck region. A meta-analysis of prospective and randomized trials. J Clin Oncol 1996;14:838–847.
  5. Forastiere AA, Goepfert H, Maor M, et al: Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091–2098.
  6. Adelstein DJ, Li Y, Adams GL, et al: An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 2003;21:92–108.
  7. Denis F, Garaud P, Bardet E, et al: Final results of the 94–01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol 2004;22:69–76.
  8. Brizel DM, Albers ME, Fisher SR, et al: Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med 1998;338:1798–1804.
  9. Wendt TG, Grabenbauer GG, Rodel CM, et al: Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer: a randomized multicenter study. J Clin Oncol 1998;16:1318–1324.
  10. Calais G, Alfonsi M, Bardet E, et al: Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst 1999;91:2081–2086.
  11. Department of Veterans Affairs Laryngeal Cancer Study Group: Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685–1690.
    External Resources
  12. Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T: Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst 1996;88:890–899.
  13. Pfister DG, Laurie SA, Weinstein GS, et al: American Society of Clinical Oncology practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 2006;24:3693–3704.
  14. Suntharalingam M, Haas ML, Van Echo DA, Haddad R, et al: Predictors of response and survival after concurrent chemotherapy and radiation for locally advanced squamous cell carcinomas of the head and neck. Cancer 2001;91:548–554.
  15. Carrillo JF, Frias-Mendivil M, Lopez-Graniel C, Beitia AI, Ochoa-Carrillo FJ: The impact of preoperative tracheotomy on T3 transglottic carcinomas of the larynx. Eur Arch Otorhinolaryngol 1999;256:78–82.
  16. MacKenzie R, Franssen E, Balogh J, Birt D, Gilbert R: The prognostic significance of tracheostomy in carcinoma of the larynx treated with radiotherapy and surgery for salvage. Int J Radiat Oncol Biol Phys 1998;41:43–51.
  17. Nikolaou A, Markou K, Petridis D, Vlachtsis K, Nalbantian M, Daniilidis L: Factors influencing tumor relapse after laryngectomy. B-ENT 2005;1:1–10.
  18. Mukherji SK, Schmalfuss IM, Castelijns J, Mancuso AA: Clinical applications of tumor volume measurements for predicting outcome in patients with squamous cell carcinoma of the upper aerodigestive tract. Am J Neuroradiol 2004;25:1425–1432.
  19. Doweck I, Denys D, Robbins KT: Tumor volume predicts outcome for advanced head and neck cancer treated with targeted chemotherapy. Laryngoscope 2002;112:1742–1749.
  20. Johansen LV, Grau C, Overgaard J: Laryngeal carcinoma – multivariate analysis of prognostic factors in 1252 consecutive patients treated with primary radiotherapy. Acta Oncol 2003;42:771–778.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: October 02, 2007
Accepted: March 11, 2008
Published online: November 04, 2008
Issue release date: November 2008

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 6

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.