Comparison of long‑term treatment outcomes of T2N0M0 laryngeal squamous cell carcinoma using different treatment methods

Jung,Eun   Kyung; Jin,Seong‑Min; Kim,Jae‑Gu; Jung,Jae‑Uk; Lee,Dong   Hoon; Lee,Joon   Kyoo; Lim,Sang   Chul; Chung, Woong‑Ki; Kim,Hee   Kyung; Hwang,Jun‑Eul; Shim,Hyun‑Jeong; Bae,Woo‑Kyun; Cho,Sang‑Hee; Chung,Ik‑Joo; Yoon,Tae   Mi

doi:10.3892/ol.2020.11628

Comparison of long‑term treatment outcomes of T2N0M0 laryngeal squamous cell carcinoma using different treatment methods

Authors:
- Eun Kyung Jung
- Seong‑Min Jin
- Jae‑Gu Kim
- Jae‑Uk Jung
- Dong Hoon Lee
- Joon Kyoo Lee
- Sang Chul Lim
- Woong‑Ki Chung
- Hee Kyung Kim
- Jun‑Eul Hwang
- Hyun‑Jeong Shim
- Woo‑Kyun Bae
- Sang‑Hee Cho
- Ik‑Joo Chung
- Tae Mi Yoon
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Affiliations: Department of Otorhinolaryngology‑Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519‑763, Republic of Korea, Department of Radiation Oncology, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519‑763, Republic of Korea, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519‑763, Republic of Korea
Published online on: May 14, 2020 https://doi.org/10.3892/ol.2020.11628
Pages: 921-930

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Abstract

Early [stage I and II (T2N0M0)] laryngeal cancer types are currently recommended to be treated with a single modality, consisting of definitive radiation therapy or larynx‑preserving surgery. Although the treatment outcomes of stage I are good, the frequency of successful outcomes decreases with T2N0M0. Therefore, the present study investigated the treatment outcomes of different treatment methods in T2N0M0 laryngeal cancer. In total, 83 patients with previously untreated T2N0M0 laryngeal squamous cell carcinoma were enrolled. Patients were grouped by treatment method: Radiation therapy (RT; 27 patients); chemoradiotherapy (CRT; 46 patients) with cisplatin base; and surgery‑based therapy (SBT; ten patients). The recurrence rates of the RT, CRT and SBT groups were 44.4, 19.6 and 50%, respectively. Moreover, the local control rates of the RT, CRT and SBT groups were 55.6, 87.0 and 80%, respectively. The CRT group had a significantly lower recurrence rate and higher local control rate compared with the RT group (P<0.05). In the survival analysis, overall and disease‑specific survival rate did not differ significantly among the treatment groups. However, 3‑ and 5‑year disease‑free survival rates (DFS) of the RT group were both 55%, those of the SBT group were both 50% and those of the CRT group were both 80%. Furthermore, the DFS was significantly higher in CRT group compared with the other groups (P=0.02). Using multivariate analysis with Cox regression, it was found that the treatment method was the most important factor for DFS and had a significant impact in the CRT group. In addition, in patients with glottic cancer with anterior commissure and subglottic invasion, the CRT group had significantly improved DFS compared with the RT group, whereas there was no significant difference between the two groups in patients without subglottic invasion. According to National Cancer Institution Common Toxicity Criteria (version 5.0), more patients had toxicity in the CRT group compared with the RT group. However, in the RT and CRT groups, no patients demonstrated mortality due to toxicity, and treatment‑related toxicities were manageable. Collectively, although definitive conclusions could not be established, due to the limitations of this retrospective study, the results suggest that CRT had a positive impact on the local control and DFS rates with manageable toxicity in patients with T2N0M0 laryngeal cancer.

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