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Laryngeal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage IV Laryngeal Cancer

Supraglottis

Standard treatment options:

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About This PDQ Summary

Purpose of This Summary This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of childhood ependymoma. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions. Reviewers and Updates This summary is reviewed regularly and updated as necessary by the PDQ Pediatric Treatment...

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  1. Total laryngectomy with postoperative radiation therapy, as evidenced in RTOG-7303, for example.[1,2,3,4,5,6,7,8]
  2. Definitive radiation therapy with surgery for salvage of radiation failures.[9]
  3. Chemotherapy administered concomitantly with radiation therapy can be considered for patients who would require total laryngectomy for control of disease. Laryngectomy would be reserved for patients with less than a 50% response to chemotherapy or who have persistent disease following radiation.[10,11,12,13,14,15]

Treatment options under clinical evaluation:

  1. Hyperfractionated radiation therapy to improve tumor control rates and diminish late toxicity to normal tissue.[3,16]
  2. Clinical trials exploring chemotherapy, radiosensitizers, or particle-beam radiation therapy.[17,18,19,20,21]

    A meta-analysis of three trials of patients with locally advanced laryngeal carcinomas compared patients who received standard radical surgery plus radiation therapy with patients who received neoadjuvant cisplatin and fluorouracil, followed by radiation therapy alone in responders or radical surgery plus radiation therapy in nonresponders.[22] The meta-analysis demonstrated a nonsignificant trend in favor of the control group, who received standard radical surgery plus radiation therapy with an absolute negative effect in the chemotherapy arm that reduced survival at 5 years by 6%. The possibility of a slightly decreased survival must be balanced by the retention of the larynx in those patients whose disease was controlled.

  3. Isotretinoin (i.e., 13-cis-retinoic acid) daily for 1 year to prevent development of second upper aerodigestive tract primary tumors.[23]

Glottis

Standard treatment options:

  1. Total laryngectomy with postoperative radiation therapy.[1,2,3,4,5,24]
  2. Definitive radiation therapy with surgery for salvage of radiation failures.[9]
  3. Chemotherapy administered concomitantly with radiation therapy can be considered for patients who would require total laryngectomy for control of disease. Laryngectomy would be reserved for patients with less than a 50% response to chemotherapy or who have persistent disease following radiation.[10,11,12,13,14,15]

Treatment options under clinical evaluation:

  1. Hyperfractionated radiation therapy to improve tumor control rates and diminish late toxicity to normal tissue.[3,16]
  2. Clinical trials exploring chemotherapy, radiosensitizers, or particle-beam radiation therapy.[17,18,20,21]

    A meta-analysis of three trials of patients with locally advanced laryngeal carcinomas compared patients who received standard radical surgery plus radiation therapy with patients who received neoadjuvant cisplatin and fluorouracil, followed by radiation therapy alone in responders or radical surgery plus radiation therapy in nonresponders.[22] The meta-analysis demonstrated a nonsignificant trend in favor of the control group who received standard radical surgery plus radiation therapy with an absolute negative effect in the chemotherapy arm that reduced survival at 5 years by 6%. The possibility of a slightly decreased survival must be balanced by the retention of the larynx in those patients whose disease was controlled.

  3. Isotretinoin daily for 1 year to prevent development of second upper aerodigestive tract primary tumors.[23]
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WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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