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Clinical outcomes and toxicity after exclusive versus postoperative radiotherapy in supraglottic cancer: new solutions for old problems? The case of stage I and II disease

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Abstract

Purpose

To compare acute and late toxicities, survival, and laryngeal preservation after radiotherapy alone (RR) or radiotherapy after partial laryngectomy (PLR) in early supraglottic laryngeal cancer.

Materials and methods

From 1984 to 2012, 172 patients were treated in our department. We analyzed and compared toxicities (CTCAE v 4.0), overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), local relapse-free survival (LRFS), nodal relapse-free survival (NRFS), metastasis-free survival (MFS), and the number of salvage total laryngectomies.

Results

Patients in the RR group were older (p = 0.05) and had more often comorbidities (p = 0.025); those in the PLR group had mostly T2 disease (p = 0.014). No difference in number of local, nodal, and distant recurrences was found. A higher incidence of late mild dry mouth in patients treated with RR (38 vs. 4 %, p = 0.000) was reported. At univariate analysis, only a younger age, a better performance status, and the absence of comorbidities favorably impacted on OS and DSS. No differences were found in DFS, LRFS, NRFS, MFS, and the number of rescue laryngectomies between the two groups. Younger age and a good performance status persisted as a predictive factor of better survival (OS and DSS) at multivariate analysis.

Conclusion

Radical radiotherapy appears to be a viable alternative to conservative surgery, even in elderly patients with poor performance status and comorbidities. Salvage laryngectomy in the RR group was compared favorably with those reported in other conservative surgery series and in the group treated postoperatively of our series.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with animals. This analysis, even if is a retrospective analysis and doesn't need a formal informed consent, has been conducted according to the ethical standards of the Institution and/or national research committee and with the 1964 Helsinki declaration and its later amendments.

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Authors and Affiliations

  1. Radiation Oncology Department, University and Spedali Civili di Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy

    Michela Buglione, Sara Pedretti, Loredana Costa, Federica Foscarini, Marta Maddalo, Ludovica Pegurri, Nadia Pasinetti, Stefano Ciccarelli, Sandro Tonoli & Stefano Maria Magrini

Authors
  1. Michela Buglione
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  2. Sara Pedretti
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  3. Loredana Costa
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  4. Federica Foscarini
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  5. Marta Maddalo
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  6. Ludovica Pegurri
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  7. Nadia Pasinetti
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  8. Stefano Ciccarelli
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  9. Sandro Tonoli
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  10. Stefano Maria Magrini
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Correspondence to Michela Buglione.

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Buglione, M., Pedretti, S., Costa, L. et al. Clinical outcomes and toxicity after exclusive versus postoperative radiotherapy in supraglottic cancer: new solutions for old problems? The case of stage I and II disease. Radiol med 120, 1071–1077 (2015). https://doi.org/10.1007/s11547-015-0533-1

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  • DOI: https://doi.org/10.1007/s11547-015-0533-1

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