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Association of Primary Tumor Volume With Survival in Patients With T3 Glottic Cancer Treated With Radiotherapy: A Study of the Canadian Head & Neck Collaborative Research Initiative.
Malik, Nauman H; Fu, Rui; Hainc, Nicolin; Noel, Christopher W; de Almeida, John R; Hosni, Ali; Hui Huang, Shao; Yu, Eugene; Dzioba, Agnieszka; Leung, Andrew; Mangat, Arvindpaul; MacNeil, Danielle; Nichols, Anthony C; Hiremath, Shivaprakash B; Chakraborty, Santanu; Jooya, Alboorz; Gaudet, Marc; Johnson-Obaseki, Stephanie; Whelan, Jonathan; Forghani, Reza; Hier, Michael P; Morand, Grégoire; Sultanem, Khalil; Dort, Joseph; Lysack, John; Matthews, Wayne; Nakoneshny, Steven; Gill, Gia; Globerman, Adam; Kerr, Paul; Maralani, Pejman; Karam, Irene; Eskander, Antoine.
Afiliação
  • Malik NH; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
  • Fu R; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
  • Hainc N; Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
  • Noel CW; Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • de Almeida JR; Department of Medical Imaging, University of Toronto, Toronto, Canada.
  • Hosni A; Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
  • Hui Huang S; Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada.
  • Yu E; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
  • Dzioba A; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
  • Leung A; Department of Medical Imaging, University of Toronto, Toronto, Canada.
  • Mangat A; Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada.
  • MacNeil D; Department of Radiology, Western University, London, Ontario, Canada.
  • Nichols AC; Department of Medical Imaging, Western University, London, Ontario, Canada.
  • Hiremath SB; Department of Radiology, Western University, London, Ontario, Canada.
  • Chakraborty S; Department of Medical Imaging, Western University, London, Ontario, Canada.
  • Jooya A; Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada.
  • Gaudet M; Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada.
  • Johnson-Obaseki S; Department of Radiology, Western University, London, Ontario, Canada.
  • Whelan J; Department of Medical Imaging, Western University, London, Ontario, Canada.
  • Forghani R; Department of Radiology, Western University, London, Ontario, Canada.
  • Hier MP; Department of Medical Imaging, Western University, London, Ontario, Canada.
  • Morand G; Division of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
  • Sultanem K; Division of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
  • Dort J; Department of Otolaryngology-Head & Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
  • Lysack J; Department of Otolaryngology-Head & Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
  • Matthews W; Department of Otolaryngology Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
  • Nakoneshny S; Department of Radiology, University of Florida College of Medicine, Gainesville.
  • Gill G; Department of Otolaryngology Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
  • Globerman A; Department of Otolaryngology Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
  • Kerr P; Department of Oncology, McGill University, Jewish General Hospital, Montréal, Québec, Canada.
  • Maralani P; Division of Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Karam I; Section of Neuroradiology, Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Eskander A; Division of Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada.
JAMA Otolaryngol Head Neck Surg ; 149(2): 103-109, 2023 02 01.
Article em En | MEDLINE | ID: mdl-36480193
Importance: The association of primary tumor volume with outcomes in T3 glottic cancers treated with radiotherapy with concurrent chemotherapy remains unclear, with some evidence suggesting worse locoregional control in larger tumors. Objective: To evaluate the association of primary tumor volume with oncologic outcomes in patients with T3 N0-N3 M0 glottic cancer treated with primary (chemo)radiotherapy in a large multi-institutional study. Design, Setting, and Participants: This multi-institutional retrospective cohort study involved 7 Canadian cancer centers from 2002 to 2018. Tumor volume was measured by expert neuroradiologists on diagnostic imaging. Clinical and outcome data were extracted from electronic medical records. Overall survival (OS) and disease-free survival (DFS) outcomes were assessed with marginal Cox regression. Laryngectomy-free survival (LFS) was modeled as a secondary analysis. Patients diagnosed with cT3 N0-N3 M0 glottic cancers from 2002 to 2018 and treated with curative intent intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Overall, 319 patients met study inclusion criteria. Exposures: Tumor volume as measured on diagnostic imaging by expert neuroradiologists. Main Outcomes and Measures: Primary outcomes were OS and DFS; LFS was assessed as a secondary analysis, and late toxic effects as an exploratory analysis determined before start of the study. Results: The mean (SD) age of participants was 66 (12) years and 279 (88%) were men. Overall, 268 patients (84%) had N0 disease, and 150 (47%) received concurrent systemic therapy. The mean (SD) tumor volume was 4.04 (3.92) cm3. With a mean (SD) follow-up of 3.85 (3.04) years, there were 91 (29%) local, 35 (11%) regional, and 38 (12%) distant failures. Increasing tumor volume (per 1-cm3 increase) was associated with significantly worse adjusted OS (hazard ratio [HR], 1.07; 95% CI, 1.03-1.11) and DFS (HR, 1.04; 95% CI, 1.01-1.07). A total of 62 patients (19%) underwent laryngectomies with 54 (87%) of these within 800 days after treatment. Concurrent systemic therapy was associated with improved LFS (subdistribution HR, 0.63; 95% CI, 0.53-0.76). Conclusions and Relevance: Increasing tumor volumes in cT3 glottic cancers was associated with worse OS and DFS, and systemic therapy was associated with improved LFS. In absence of randomized clinical trial evidence, patients with poor pretreatment laryngeal function or those ineligible for systemic therapy may be considered for primary surgical resection with postoperative radiotherapy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 1_ASSA2030 Problema de saúde: 1_sistemas_informacao_saude Assunto principal: Neoplasias da Língua / Carcinoma de Células Escamosas / Neoplasias Laríngeas Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: JAMA Otolaryngol Head Neck Surg Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Canadá
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 1_ASSA2030 Problema de saúde: 1_sistemas_informacao_saude Assunto principal: Neoplasias da Língua / Carcinoma de Células Escamosas / Neoplasias Laríngeas Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: JAMA Otolaryngol Head Neck Surg Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Canadá