Performance and quality of life outcomes for T4 laryngeal cancer patients treated with induction chemotherapy followed by chemoradiotherapy

• Published in: Oral oncology Vol. 48; no. 10; pp. 1025 - 1030
• Main Authors: Mouw, Kent W, Solanki, Abhishek A, Stenson, Kerstin M, Witt, Mary Ellyn, Blair, Elizabeth A, Cohen, Ezra E.W, Vokes, Everett E, List, Marcy, Haraf, Daniel J, Salama, Joseph K
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.10.2012; Elsevier
• Subjects: Adult; Aged; Antimetabolites, Antineoplastic - administration & dosage; Antineoplastic Agents - administration & dosage; Antineoplastic Agents, Phytogenic - administration & dosage; Antineoplastic Combined Chemotherapy Protocols; Biological and medical sciences; Carboplatin - administration & dosage; Chemoradiotherapy - methods; Female; Fluorouracil - administration & dosage; Head and neck cancer; Hematology, Oncology and Palliative Medicine; Humans; Hydroxyurea - administration & dosage; Induction Chemotherapy - methods; Laryngeal cancer; Laryngeal Neoplasms - therapy; Male; Medical sciences; Middle Aged; Organ-sparing; Otolaryngology; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Paclitaxel - administration & dosage; Quality of Life; Radiotherapy; Risk Factors; Squamous cell carcinoma; Time Factors; Treatment Outcome; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Laryngeal cancer; Head and neck cancer; Squamous cell carcinoma; Radiotherapy; Organ-sparing; Quality of life; Performance evaluation; Human; Skin disease; Basal cell carcinoma; Prognosis; Induction; Stomatology; ENT; Malignant tumor; Chemoradiotherapy; Chemotherapy; Cancerology; Treatment; ENT disease; Larynx disease; Cancer; Organ
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2012.04.004

Summary Organ-sparing approaches with chemoradiotherapy are often used in the treatment of patients with laryngeal cancer, and the oncologic outcomes of these patients are similar to patients who undergo laryngectomy. However, chemoradiotherapy for laryngeal cancer patients with large or locally-invasive (T4) tumors has been more slowly incorporated due to concern for poor post-treatment function of the preserved larynx. Here, we characterize acute and long-term performance and quality-of-life (QOL) outcomes of T4 laryngeal cancer patients treated with induction chemotherapy followed by combined chemoradiotherapy. Using several validated metrics, we find patients experience a decline in most measures of performance and QOL during and immediately following treatment. However, the majority of patients improve to baseline over varying lengths of time following completion of treatment, and many go on to exceed pre-treatment levels of function. Gender, race, alcohol, and tobacco usage were found to be associated with differences in performance and QOL scores across time points. This study suggests that patients with advanced laryngeal tumors who historically had been considered poor candidates for organ-sparing treatment are able to return to, and in many cases exceed pre-treatment performance and QOL following induction chemotherapy and combined chemoradiotherapy.