Recurrent Laryngeal Cancer
Treatment of recurrent supraglottic, glottic, and subglottic cancer includes further surgery or clinical trials.[1,2,3,4]
Standard treatment options:
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- Surgery [5] and/or radiation therapy. Salvage is possible for failures of surgery alone or of radiation therapy alone, and further surgery [5] and/or radiation therapy should be attempted, as indicated. Selected patients may be candidates for partial laryngectomy after high-dose radiation therapy has failed.[6]
- Radiation therapy. Re-irradiation for laryngeal salvage following radiation therapy failure has resulted in long-term survival in a small number of patients; it may be considered for small recurrences after radiation therapy, especially in patients who refuse or are not candidates for laryngectomy.[7]
- Chemotherapy. A response of variable duration may be achieved after systemic chemotherapy.[8]
Salvage after previous combined total laryngectomy and radiation therapy is poor.
Treatment options under clinical evaluation:
- Patients whose disease does not respond to combined radiation therapy and surgery probably are best treated by palliative chemotherapy in clinical trials.
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent laryngeal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
References:
- Million RR, Cassisi NJ, eds.: Management of Head and Neck Cancer: A Multidisciplinary Approach. Philadelphia, Pa: Lippincott, 1994.
- Wang CC, ed.: Radiation Therapy for Head and Neck Neoplasms. 3rd ed. New York: Wiley-Liss, 1997.
- Vikram B, Strong EW, Shah JP, et al.: Intraoperative radiotherapy in patients with recurrent head and neck cancer. Am J Surg 150 (4): 485-7, 1985.
- Jacobs C, Lyman G, Velez-García E, et al.: A phase III randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck. J Clin Oncol 10 (2): 257-63, 1992.
- Wong LY, Wei WI, Lam LK, et al.: Salvage of recurrent head and neck squamous cell carcinoma after primary curative surgery. Head Neck 25 (11): 953-9, 2003.
- Lavey RS, Calcaterra TC: Partial laryngectomy for glottic cancer after high-dose radiotherapy. Am J Surg 162 (4): 341-4, 1991.
- Wang CC, McIntyre J: Re-irradiation of laryngeal carcinoma--techniques and results. Int J Radiat Oncol Biol Phys 26 (5): 783-5, 1993.
- Al-Sarraf M: Head and neck cancer: chemotherapy concepts. Semin Oncol 15 (1): 70-85, 1988.
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