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Utility of bioselection with neoadjuvant chemotherapy for organ preservation in patients with T4 laryngeal cancer.
Benjamin, William J; Feng, Allen L; Heft Neal, Molly; Bellile, Emily; Casper, Keith A; Malloy, Kelly M; Rosko, Andrew J; Stucken, Chaz L; Prince, Mark E; Mierzwa, Michelle L; Taylor, Jeremy M G; Eisbruch, Avraham; Spector, Matthew E; Wolf, Gregory T; Swiecicki, Paul L; Worden, Francis P; Chinn, Steven B.
Afiliación
  • Benjamin WJ; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA; Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
  • Feng AL; Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
  • Heft Neal M; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Bellile E; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Casper KA; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Malloy KM; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Rosko AJ; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Stucken CL; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Prince ME; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Mierzwa ML; Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
  • Taylor JMG; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA; The Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
  • Eisbruch A; Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.
  • Spector ME; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Wolf GT; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Swiecicki PL; Department of Internal Medicine, Medical Oncology, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
  • Worden FP; Department of Internal Medicine, Medical Oncology, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
  • Chinn SB; Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA. Electronic address: schinn@med.umich.edu.
Oral Oncol ; 156: 106917, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38945011
ABSTRACT

BACKGROUND:

Neoadjuvant chemotherapy for induction selection of definitive treatment (IS) protocols have shown excellent outcomes for organ preservation and survival in patients with T3 laryngeal squamous cell carcinoma (LSCC). We seek to evaluate survival and organ preservation outcomes in T4 LSCC patients treated with IS protocols.

METHODS:

Retrospective cohort of advanced T3 and T4 LSCC patients who underwent IS protocols based upon potential for preserving a functional larynx. Patients received one neoadjuvant cycle of platinum-based chemotherapy with either 5-fluorouracil or docetaxel or with two cycles of platinum-based chemotherapy with docetaxel and a Bcl-2 inhibitor. Patients who achieved ≥ 50 % response as determined by radiographic review and/or endoscopic evaluation received definitive chemoradiation. Patients who had < 50 % response after IS underwent total laryngectomy (TL) followed by post-operative radiation +/- chemotherapy.

RESULTS:

Amongst T4 patients, 114 met inclusion criteria including 89 who underwent IS protocols and 25 who received an upfront TL. In total, 76.0 % of T3 patients and 71.9 % of T4 patients responded to IS and underwent definitive chemoradiation. There was no significant difference in hazard of death between T4 IS and T4 TL patients (HR 0.9, p = 0.86). Among responders, there was no significant difference in 5-year laryngectomy-free survival (T3 - 59.6 %, T4 44.3 %, p = 0.15) or laryngeal preservation by T stage (T3 - 72.8 %, T4 - 73.0 %, p = 0.84).

CONCLUSIONS:

Select T4 patients may benefit from organ preservation using IS protocols with similar response rates to patients with T3 tumors, without compromising survival when compared to upfront TL.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Laríngeas / Terapia Neoadyuvante Idioma: En Revista: Oral Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Laríngeas / Terapia Neoadyuvante Idioma: En Revista: Oral Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article