Article Abstract

Analysis of prognostic factors, including the incidence of second primary cancer, in patients with early stage laryngeal squamous cell carcinoma treated by radiation-based therapy

Authors: Kaname Sato, Kenichiro Yabuki, Daisuke Sano, Yasuhiro Arai, Yoshihiro Chiba, Teruhiko Tanabe, Goshi Nishimura, Masaharu Hata, Nobuhiko Oridate


Background: The purpose of this study was to elucidate the efficacy of concurrent chemotherapy and analyze prognostic factors in the radiation-based therapy for early stage laryngeal squamous cell carcinoma (ELSCC).
Methods: The records of 97 patients with ELSCC treated by radiation-based therapy from 2004 to 2016 were retrospectively reviewed. Eighty-one patients were treated with the combined-agent regimens during the treatment. Of the 81 patients, 58 were treated with S-1 regimen and 23 with other regimens. Clinical factors, such as concurrent chemotherapy, non-glottic subsite and the incidence of second primary cancer (SPC) were analyzed for their association with survival.
Results: From the analysis of all patients, the 5-year overall survival (OS) rates were found to be significantly poorer for patients with non-glottic cancer compared to those with glottic cancer (P<0.001), and non-glottic subsite was shown to be the only poor prognostic factor for OS by the multivariate analysis (P=0.006). SPC was responsible for two-thirds of all deaths. In the analysis of patients with stage II ELSCC, the 5-year disease-free survival (DFS) rates were significantly better for patients treated by concurrent chemoradiotherapy (CCRT) with S-1 compared to those treated by the other treatment methods, and a combination with the S-1 regimen was shown to be the only good prognostic factor for DFS by the multivariate analysis (P=0.015).
Conclusions: Non-glottic subsite and SPC were associated with worsened survival. CCRT with S-1 can be a useful treatment option for stage II ELSCC.