2015 Volume 144 Pages 68-69
Laryngeal cancer is the third most common of the head and neck cancers in Japan. We retrospectively analyzed the data of 112 newly diagnosed patients with laryngeal cancer who were treated at our department between 2005 and 2012. The subjects consisted of 102 males and 10 females, ranging in age from 40 to 88 years (average, 69.2 years). The follow-up period ranged from 1 to 95 months (median: 33 months).
Our treatment protocol was as follows: Patients with T1a glottic or T1 supra/subglottic cancer were administered radiotherapy alone at 60 Gy/30 fractions. Patients with T1b glottic or T2 cancer received hyperfractionated radiotherapy with concurrent daily carboplatin (25 mg/m2). Responders at 30–40 Gy continued receiving chemoradiotherapy up to a total of 64.8 Gy, whereas nonresponders underwent surgery. For patients with T3 or T4 cancer, 1–2 courses of induction chemotherapy (docetaxel 60 mg/m2 (day 1), cisplatin 60 mg/m2 (day 1), and 5-fluorouracil 600 mg/m2 (days 1–5)) were administered. Responders among the T3 patients were given hyperfractionated radiotherapy with concurrent daily carboplatin, whereas all T4 patients and nonresponder T3 patients were treated by surgery after induction chemotherapy.
The overall 5-year crude survival, disease-specific survival and laryngeal preservation rates as determined by the Kaplan-Meier method were 73.5%, 81.9% and 64.2%, respectively. The survival rates were significantly higher in patients with stage I/II disease than in those with stage III/IV disease (stage I: 93.8% (crude)/100% (disease-specific), stage II: 93.3%/100%, stage III: 62.1%/80.8%, stage IV: 24.2%/31.2%). The laryngeal preservation rate was significantly higher in patients with T1/2 disease than in those with T3/4 disease (T1: 89.7%, T2: 92.0%, T3: 19.3%, T4: 0.0%). The survival rate of patients with stage IV disease and the laryngeal preservation rate of patients with T3 disease were somewhat low and unsatisfactory as compared to previous reports.
These results indicate the importance of early detection and the need for improvement of the treatment protocol for stage IV/T3 cases.
