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Efficacy and toxicity of (chemo)radiotherapy for primary subglottic cancer

Wirksamkeit und Toxizität der (Chemo-)Radiotherapie bei primärem subglottischem Karzinom

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Abstract

Background and purpose

Primary subglottic cancer is a rare malignancy. We investigated the efficacy and toxicity of radiotherapy for subglottic cancer.

Patients and methods

Nineteen patients with primary squamous cell carcinoma of the subglottis received radiotherapy, 14 of whom also underwent chemotherapy. Of the 19 patients, 15 received definitive radiotherapy to the gross tumors with total doses of 70–70.2 Gy in 35–39 fractions, and 4 underwent preoperative radiotherapy with total doses of 37.8–55.8 Gy in 21–31 fractions, followed by total laryngectomy.

Results

Of the 19 patients, 5 developed local progression and 2 developed distant metastasis at the median follow-up period of 5 years. The 5-year local control and disease-free rates were 74 and 63%, respectively. Three patients died of tumor progression, and the 5-year overall and disease-free survival rates were 80 and 63%, respectively. Regarding acute toxicities, transient mucositis and dermatitis of grade 3 or lower were observed in all patients, but there were no late toxicities of grade 3 or higher.

Conclusion

Radiotherapy is a safe and effective treatment for patients with primary squamous cell carcinoma of the subglottis. The use of chemotherapy together with radiotherapy may enhance treatment efficacy and contribute to larynx preservation through good local control.

Zusammenfassung

Hintergrund und Ziel

Ein primäres subglottisches Karzinom ist ein seltenes Malignom. Wir untersuchten die Wirksamkeit und Toxizität der Radiotherapie bei subglottischem Karzinom.

Patienten und Methoden

Radiotherapie erhielten 19 Patienten mit primärem Plattenepithelkarzinom der Subglottis, 14 dieser Patienten wurden außerdem auch chemotherapeutisch behandelt. Bei 15 der 19 Patienten wurde die Tumormasse mit einer in 35–39 Fraktionen aufgeteilten, im Rahmen der definitiven Radiotherapie verabreichten Gesamtdosis von 70–70,2 Gy behandelt; und bei 4 Patienten erfolgte eine präoperative Radiotherapie mit einer in 21–31 Fraktionen aufgeteilten Gesamtdosis von 37,8–55,8 Gy mit anschließender totaler Laryngektomie.

Ergebnisse

Von den 19 Patienten entwickelten im mittleren Nachbeobachtungszeitraum von 5,0 Jahren 5 eine lokale Progression und 2 Fernmetastasen. Die 5-Jahres-Raten für lokale Kontrolle und Krankheitsfreiheit betrugen 74 bzw. 63%. Drei Patienten verstarben aufgrund von Tumorprogression, und die 5-Jahres-Raten für Gesamtüberleben und krankheitsfreies Überleben lagen bei 80 bzw. 63%. Hinsichtlich akuter Toxizitäten wurde bei allen Patienten vorübergehende Mukositis und Dermatitis mit einem Schweregrad bis zu Grad 3 beobachtet, aber es gab keine Spättoxizitäten von mehr als Grad 3.

Schlussfolgerung

Die Radiotherapie stellt eine sichere und effektive Behandlung für Patienten mit primärem Plattenepithelkarzinom der Subglottis dar. Der Einsatz von Chemotherapie in Verbindung mit Radiotherapie kann die Behandlungseffizienz erhöhen und durch gute lokale Kontrolle zur Erhaltung des Larynx beitragen.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-0004, Yokohama, Japan

    M. Hata MD, I. Koike, K. Odagiri, Y. Minagawa & T. Inoue

  2. Department of Otorhinolaryngology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    T. Taguchi, G. Nishimura, M. Takahashi, M. Komatsu & D. Sano

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  1. M. Hata MD
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  2. T. Taguchi
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  3. I. Koike
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  4. G. Nishimura
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  5. M. Takahashi
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  6. M. Komatsu
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Correspondence to M. Hata MD.

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Hata, M., Taguchi, T., Koike, I. et al. Efficacy and toxicity of (chemo)radiotherapy for primary subglottic cancer. Strahlenther Onkol 189, 26–32 (2013). https://doi.org/10.1007/s00066-012-0178-0

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