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Effectiveness of chemotherapy and radiotherapy for laryngeal preservation in advanced laryngeal cancer: a meta-analysis and systematic review

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Abstract

Purpose

This meta-analysis compared the efficacy of laryngectomy and three larynx-preservation treatments in patients with advanced laryngeal cancer.

Materials and methods

Medline, Cochrane, EMBASE and Google Scholar databases were searched (until May 5, 2014) for studies that evaluated total laryngectomy followed by radiation and three larynx-preserving strategies in patients with advanced laryngeal cancer. The outcomes assessed were the 2- to 5-year overall survival (OS), disease-free survival (DFS), and laryngectomy-free survival (LFS)

Results

The search identified ten studies which were used for the meta-analysis (N = 2013 patients). The meta-analysis found that among different treatments, RT alone was associated with the highest rate of OS (71.6 %), DFS (57.8 %), and LFS (79.0 %). OS was similar among the following treatments: laryngectomy→RT vs. CT→RT [P = 0.402]; RT+CT vs. RT alone [P = 0.440]; and RT+CT vs CT→RT [P = 0.588]. DFS rate was higher in patients receiving laryngectomy→RT than CT→RT (P = 0.001) and was similar for RT+CT compared with CT→RT (P = 0.590).

Conclusion

These findings suggest that of the larynx-preserving treatments, RT alone was associated with highest rates of OS, DFS, and LFS in patients with locally advanced cancer of the larynx and hypopharynx. Laryngectomy provided a better rate of DFS than CT and RT, but OS were similar across the different larynx-preserving treatments and laryngectomy.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

Meta-analyses do not involve human subjects and do not require IRB review (J Grad Med Educ. 2011 March; 3(1): 5–6).

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People’s Republic of China

    Xiao-Ning Luo, Liang-Si Chen, Si-Yi Zhang, Zhong-Ming Lu & Yan Huang

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  1. Xiao-Ning Luo
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  2. Liang-Si Chen
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  3. Si-Yi Zhang
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  4. Zhong-Ming Lu
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  5. Yan Huang
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Correspondence to Xiao-Ning Luo.

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Luo, XN., Chen, LS., Zhang, SY. et al. Effectiveness of chemotherapy and radiotherapy for laryngeal preservation in advanced laryngeal cancer: a meta-analysis and systematic review. Radiol med 120, 1153–1169 (2015). https://doi.org/10.1007/s11547-015-0547-8

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  • DOI: https://doi.org/10.1007/s11547-015-0547-8

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