Skip to main content
SpringerLink
Log in

Chemoradiotherapy vs radiotherapy for non-surgical locally advanced laryngeal squamous cell carcinoma patients: a propensity score-matched study and practical nomogram construction

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

To compare the cancer-specific survival (CSS) among patients with locally advanced laryngeal squamous cell carcinoma (LSCC) receiving chemoradiotherapy (CRT) and radiotherapy (RT) treatment, as well as to establish a prognostic nomogram for survival prediction in patients receiving CRT.

Method

Using data from the Surveillance, Epidemiology, and End Results (SEER) database, patients with laryngeal cancer were identified between 2010 and 2015, with follow-up up to 2018. Propensity score matching (PSM) was performed to minimize disproportionate distributions of the potential confounding. Cox regression models were used to evaluate the CSS of two treatment groups. A prognostic nomogram for patients receiving CRT was then developed and evaluated.

Results

Totally 1085 non-surgical patients with locally advanced LSCC were included in this study (median [IQR] age, 62 [55–69] years; 829 [76.41%] males), of which 913 receiving CRT and 172 receiving RT. After PSM, significantly improved CSS was observed in locally advanced LSCC patients receiving CRT when compared to RT (HR: 0.62 [95% CI 0.42–0.92]; P = 0.014). Then, in the group of 639 locally advanced LSCC patients receiving CRT, a prognostic nomogram based on age, tumor size, N category, and marital status were developed and validated, of which the predictive performance was superior to that of TNM staging system (7th edition).

Conclusion

CSS shows a statistically significant improvement in locally advanced LSCC patients who receipt of CRT when compared with RT. Furthermore, a prognostic nomogram for locally advanced LSCC patients receiving CRT was established, which shows a good calibration and identification accuracy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

All methods were carried out in accordance with relevant guidelines and regulations. The data that support the findings of this study are openly available in SEER database at https://seer.cancer.gov/.

References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics. Cancer J Clin 65(2):87–108

    Article  Google Scholar 

  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424

    Article  PubMed  Google Scholar 

  3. Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF (2017) An update on larynx cancer. Cancer J Clin 67(1):31–50

    Article  Google Scholar 

  4. Randa O, Magi R, Chafeek T (2019) The treatment of laryngeal cancer. Oral Maxillofac Surg Clin N Am 31(1):1–11

    Article  Google Scholar 

  5. Pfister DG, Laurie SA, Weinstein GS (2006) American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 24:3693–3704

    Article  PubMed  Google Scholar 

  6. Wolf GT, Fisher SG, Hong WK, Hillman R, Spaulding M, Laramore GE (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324:1685–1690

    Article  PubMed  Google Scholar 

  7. Karlsson TR, Al-Azzawe M, Aziz L et al (2014) Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres. Eur Arch Otorhinolaryngol 271:547–554

    Article  PubMed  Google Scholar 

  8. National Comprehensive Cancer Network (NCCN) (2017). Clinical practice guidelines in oncology. Head and Neck Cancer. https://www.nccn.org/professionals/physician_gls/. Accessed 30 Oct 2019.

  9. Cohen EE, Karrison TG, Kocherginsky M, Mueller J, Egan R, Huang CH, Samant S (2014) Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer. J Clin Oncol 32(25):2735–2743

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Haddad R, O’Neill A, Rabinowits G, Tishler R, Khuri F, Adkins D, Limaye S (2013) Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial. Lancet Oncol 14(3):257–264

    Article  CAS  PubMed  Google Scholar 

  11. Kitani Y, Kubota A, Furukawa M, Sato K (2016) Prognostic factors for local control in patients receiving radiation therapy for early glottic cancer: anterior commissure involvement and effect of chemoradiotherapy. Eur Arch Otorhinolaryngol 273:1011–1017

    Article  PubMed  Google Scholar 

  12. Lagha A, Chraiet N, Labidi S, Rifi H, Ayadi M, Krimi S, Kochbati L (2013) Larynx preservation: what is the best non-surgical strategy? Crit Rev Oncol Hematol 88(2):447–458

    Article  PubMed  Google Scholar 

  13. Forastiere AA, Zhang Q, Weber RS, Maor MH, Goepfert H, Pajak TF, Thorstad W (2013) Long-term results of RTOG 91–11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 31(7):845–852

    Article  CAS  PubMed  Google Scholar 

  14. Karlsson TR, Al-Azzawe M, Aziz L, Hurman D, Finizia C (2014) Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres. Eur Arch Otorhinolaryngol 271(3):547–554

    Article  PubMed  Google Scholar 

  15. Department of Veterans Affairs Laryngeal Cancer Study Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324(24):1685–1690

    Article  Google Scholar 

  16. Wolf GT, Bellile E, Eisbruch A (2017) Survival rates using individualized bioselection treatment methods in patients with advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg 143:355–366

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bonner J, Giralt J, Harari P (2016) Cetuximab and radiotherapy in laryngeal preservation for cancers of the larynx and Hypopharynx: a secondary analysis of a randomized clinical trial. JAMA Otolaryngol Head Neck Surg 142:842–849

    Article  PubMed  PubMed Central  Google Scholar 

  18. Leoncini E, Vukovic V, Cadoni G (2018) Tumour stage and gender predict recurrence and second primary malignancies in head and neck cancer: a multicentre study within the INHANCE consortium. Eur J Epidemiol 33:1205–1218

    Article  PubMed  PubMed Central  Google Scholar 

  19. Li ZQ, Zou L, Liu TR, Yang AK (2015) Prognostic value of body mass index before treatment for laryngeal squamous cell carcinoma. Cancer Biol Med 12:394–400

    PubMed  PubMed Central  Google Scholar 

  20. Daneshi N, Fararouei M, Mohammadianpanah M et al (2018) Effects of different treatment strategies and tumor stage on survival of patients with advanced laryngeal carcinoma: a 15-year cohort study. J Cancer Epidemiol 2018:9678097

    Article  PubMed  PubMed Central  Google Scholar 

  21. Balachandran VP, Gonen M, Smith JJ, DeMatteo RP (2015) Nomograms in oncology: more than meets the eye. Lancet Oncol 16(4):e173–e180

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zhu X, Heng Y, Zhou L et al (2019) A prognostic nomogram for predicting risk of recurrence in laryngeal squamous cell carcinoma patients after tumor resection to assist decision making for postoperative adjuvant treatment. J Surg Oncol 120:698–706

    Article  PubMed  Google Scholar 

  23. Chen F, Lin L, Liu F, Yan L, Qiu Y, Wang J, Wang R (2019) Three prognostic indexes as predictors of response to adjuvant chemoradiotherapy in patients with oral squamous cell carcinoma after radical surgery: a large-scale prospective study. Head Neck 41(2):301–308

    Article  PubMed  Google Scholar 

  24. Santoro L, Tagliabue M, Massaro MA, Ansarin M, Calabrese L, Giugliano G, Benazzo M (2015) Algorithm to predict postoperative complications in oropharyngeal and oral cavity carcinoma. Head Neck 37(4):548–556

    Article  PubMed  Google Scholar 

  25. Hay A, Migliacci J, Zanoni DK, Patel S, Yu C, Kattan MW, Ganly I (2018) Validation of nomograms for overall survival, cancer-specific survival, and recurrence in carcinoma of the major salivary glands. Head Neck 40(5):1008–1015

    Article  PubMed  PubMed Central  Google Scholar 

  26. Petersen JF, Stuiver MM, Timmermans AJ, Chen A, Zhang H, O’Neill JP, Skroder C (2018) Development and external validation of a risk-prediction model to predict 5-year overall survival in advanced larynx cancer. Laryngoscope 128(5):1140–1145

    Article  PubMed  Google Scholar 

  27. Sawant SS, Dongre H, Ahire C, Sharma S, Kannan S, Mahadik S, Vaidya MM (2017) A nomogram for predicting the risk of neck node metastasis in pathologically node-negative oral cavity carcinoma. Oral Dis 23(8):1087–1098

    Article  CAS  PubMed  Google Scholar 

  28. Wang SJ, Patel SG, Shah JP, Goldstein DP, Irish JC, Carvalho AL, Gross ND (2013) An oral cavity carcinoma nomogram to predict benefit of adjuvant radiotherapy. JAMA Otolaryngol Head Neck Surg 139(6):554–559

    PubMed  Google Scholar 

  29. Sheu T, Fuller CD, Mendoza TR, Garden AS, Morrison WH, Beadle BM, Cleeland CS (2014) Nomogram for predicting symptom severity during radiation therapy for head and neck cancer. Otolaryngology Head Neck Surg 151(4):619–626

    Article  Google Scholar 

Download references

Funding

No funding has been received for this work.

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China

    Yuan Zhang & Yun Zheng

  2. Department of Audiology, Guizhou Provincial People’s Hospital, Guiyang, China

    Yuan Zhang & Zhipeng Wang

Authors
  1. Yuan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhipeng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yun Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

YZ and YZ performed the formal analysis; ZW and YZ performed the data analysis; Yuan Zhang wrote the manuscript.

Corresponding author

Correspondence to Yun Zheng.

Ethics declarations

Conflict of interest

We declare no conflict of interest.

Ethical approval

Not applicable. This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 2827 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Y., Wang, Z. & Zheng, Y. Chemoradiotherapy vs radiotherapy for non-surgical locally advanced laryngeal squamous cell carcinoma patients: a propensity score-matched study and practical nomogram construction. Eur Arch Otorhinolaryngol 281, 1449–1456 (2024). https://doi.org/10.1007/s00405-023-08360-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-023-08360-8

Keywords

Search

Navigation