Prognostic significance of pretreatment hemoglobin for local control and overall survival in T1-T2N0 larynx cancer treated with external beam radiotherapy

2004 ◽  
Vol 58 (4) ◽  
pp. 1135-1140 ◽  
Author(s):  
Edward I Cho ◽  
Clarence T Sasaki ◽  
Bruce G Haffty
Keyword(s):  
Overall Survival ◽  
Local Control ◽  
External Beam Radiotherapy ◽  
Prognostic Significance ◽  
Larynx Cancer ◽  
External Beam

Intensity modulated radiation therapy boost in locally-advanced cervical cancer in the absence of brachytherapy

2020 ◽  
Vol 30 (5) ◽  
pp. 607-612 ◽  
Author(s):  
Roberta Lazzari ◽  
Giulia Riva ◽  
Matteo Augugliaro ◽  
Andrea Vavassori ◽  
Samantha Dicuonzo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Lymph Nodes ◽  
Local Control ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Intensity Modulated Radiation Therapy ◽  
Progression Free Survival ◽  
External Beam ◽  
Tumor Persistence

ObjectiveStandard treatment in locally-advanced cervical cancer is external beam radiotherapy concomitant with platinum-based chemotherapy, followed by brachytherapy. The goal of our study was to determine whether an intensity modulated radiation therapy (IMRT) boost is feasible in patients unfit for brachytherapy.MethodsWe retrospectively analyzed data of 25 patients unfit for brachytherapy with median age 55 years (range, 30–82) with locally-advanced/metastatic cervical cancer who underwent external beam radiotherapy to pelvis ±para-aortic lymph nodes and sequential IMRT boost between July 2014 and December 2017. Total dose of 45–50.4 Gy in 25–28 fractions (1.8 Gy/fraction) was administered to the cervix, uterus, parametria, ovaries, vaginal tissues (based on vaginal extension), involved lymph nodes, or relevant draining lymph-nodal groups. Para-aortic nodes were included if involved at radiological staging or if common iliac nodes were positive. The IMRT boost included all residual tumor after external beam radiotherapy identified on MRI. The Kaplan–Meier method was used to calculate 2 years' overall survival, 2 years' progression-free survival, and 2 years' local control. Overall survival- and progression-free survival were calculated considering the starting of radiotherapy or neo-adjuvant chemotherapy if prescribed, while local control was calculated from the end of radiotherapy.ResultsMedian radiation dose to pelvis ±para-aortic lymph nodes was 50.4 Gy (45–50.4), boost treatment was homogeneously performed to a total dose of 25 Gy in five fractions every other day.After a median follow-up of 26 months (range, 4–77), tumor persistence at cervix at 6 months from the end of radiotherapy or local recurrence occurred in five women (20%), eight (32%) experienced a further distant progression (two of them had also tumor persistence). Two-year local control and overall survival rates for all stages were 78% and 67%, respectively. According to Common Terminology Criteria for Adverse Events v.4 scoring criteria, 10 patients experienced gastrointestinal and/or genitourinary grade G1-2 acute toxicity. G2 rectal late toxicity requiring laser-coagulation was registered in two patients, there were no gastrointestinal and/or genitourinary acute or late toxicities≥G3.ConclusionThe combination of external beam radiotherapy and brachytherapy remains the standard of care, however our preliminary data show the feasibility of IMRT boost in terms of toxicity with promising results in terms of local control and overall survival.

T1/T2 glottic cancer managed by external beam radiotherapy—The influence of beam energy on local control

1998 ◽  
Vol 42 (1) ◽  
pp. 328 ◽  
Author(s):  
Padraig R. Warde ◽  
Brian O'Sullivan ◽  
Tony Panzarella ◽  
David G. Payne ◽  
Fei-Fei Liu ◽  
...  
Keyword(s):  
Local Control ◽  
Beam Energy ◽  
External Beam Radiotherapy ◽  
Glottic Cancer ◽  
External Beam

Association of tumor volume and outcomes in T3 larynx cancer with organ preservation approach.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18044-e18044
Author(s):  
Nauman Malik ◽  
Nicolin Hainc ◽  
Gia Gill ◽  
Steven Nakoneshny ◽  
Paul Kerr ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Local Control ◽  
Systemic Therapy ◽  
Retrospective Cohort Study ◽  
Organ Preservation ◽  
Retrospective Cohort ◽  
Tumor Volume ◽  
Local Failure ◽  
Larynx Cancer

e18044 Background: Organ preservation approaches to treatment of locally advanced larynx cancers are widely used and consist of radiotherapy (RT) with or without concurrent systemic therapy (CRT). Analyses of the National Cancer Database point to decreasing survival as CRT became widely adopted in place of total laryngectomy (TL). Tumor volume in T3 laryngeal tumors has been postulated as one variable to explain this finding, with higher volume associated with lower local control based on small sample size studies largely in pre-intensity modulated radiotherapy (IMRT) era, and low volume T3 tumors being associated with improved local control with CRT. We sought to validate these findings in a contemporary cohort of T3 larynx patients treated with IMRT. Methods: This was a national, multicentre retrospective cohort study of patients diagnosed with American Joint Committee on Cancer (AJCC) T3 N0-3 M0 glottic and supraglottic cancers who underwent curative intent IMRT with or without systemic treatment from 2002-2018. Tumor volumes were calculated using a validated standardized approach by a Neuroradiologist. Primary predictor was tumor volume, primary outcome was local control (LC), and secondary outcomes included overall survival (OS), as well as late grade 3+ toxicities. Kaplan Meier estimates and log-rank tests were used for survival analyses, with Cox proportional hazards used for univariable analyses. Results: 246 patients met inclusion criteria, 147 glottic and 99 supraglottic cancers. At baseline, glottic patients were more likely to be male (p < 0.01), have a fixed vocal cord (p < 0.01), not have pre-epiglottic space invasion ( < 0.01), be cN0 (p < 0.01), and have lower grade tumors (p < 0.01). Mean tumor volumes for glottic and supraglottic tumors were 5.0 (4.2-5.8) cc and 13.0 (10.3–15.6) cc respectively. Univariable analysis showed systemic therapy was associated with improved local failure (HR 0.49, 95%CI 0.24 – 0.99, p = 0.05). Within the glottic cohort, tumor volume was not associated with local failure (HR 1.09, 95%CI 0.71 – 1.67, p = 0.38), however having a local failure event was associated with increased feeding tube dependence (HR 2.52, 95%CI 1.05 – 6.02, p = 0.04). Median local failure free survival in the overall cohort was 28.5 months, with median OS 23.2 months. There was a trend towards improved local control in the supraglottic cohort compared to glottic patients (log-rank p = 0.08), but the supraglottic cohort had significantly worse overall survival (log-rank p = 0.02). Conclusions: In this retrospective cohort study, there were baseline and outcome differences between patients with T3 glottic and supraglottic larynx cancer, with worse overall survival in supraglottic patients. Tumor volume was not associated with local control in the glottic cohort. These findings are pending further validation in a larger cohort and will be analyzed separately for supraglottic tumors.

scholarly journals A Comparative Study of Result of Treatment of Cancer Cervix Patients Treated by Two Separate Schedules of Radiotherapy

2013 ◽  
Vol 25 (2) ◽  
pp. 50-58 ◽  
Author(s):  
Parveen Shahida Akhtar ◽  
M Md Shakhawat Hossain ◽  
Zafor Md Masud ◽  
Naheed Ruksana ◽  
Shamsun Nahar ◽  
...  
Keyword(s):  
Overall Survival ◽  
Open Field ◽  
Local Control ◽  
External Beam ◽  
Cancer Cervix ◽  
Carcinoma Cervix ◽  
Who Grade ◽  
Group I ◽  
Group Ii ◽  
Age Range

Background: Cervical cancer is the most common cancer of Bangladeshi women diagnosed mostly (>80%) at stage II and stage III. Rdaiotherapy (both teletherapy and brachytherapy) is the most important modality of treatment at these stages.Objective: To compare the local control, diseases free survival and overall survival between the (cancer cervix) patients treated randomly by two schedules of radiotherapy. Method: From June 1996 to June 2005, patients with histologically confirmed carcinoma cervix (Ca.cervix) were treated by external beam therapy (EBRT) as well as intra cavitery brachytherapy (ICRT) along with concurrent/sequential chemotherapy with cisplatin and 5- Fluorouracil. EBRT was given by cobalt60 teletherapy machine and ICRT by caesium137 low dose rate machine. The patients were divided into two groups according to treatment schedules. Group I: the patients in this group received EBRT in whole pelvis in two steps, first with open field upto 10-20 Gy then by applying midline shield with lead block 30-40Gy in 25-28 total fractions, five days a week; they also received 50-70 Gy to point A by ICRT in 2-4 weekly fractions. Group II: patients in this group received with open field a dose of 45-50Gy in 25-28 fractions, 5 days a week by EBRT and 25-30 Gy at point A by ICRT in 1-2 weekly fractions.Result: In Group I, 96 out of 101 and in Group II, 104 out of 118 patients were eligible for evaluation. In both groups patients were distributed according to stages and age more or less equally; their age range were 30-70 years and mean age was 47.2 years in Group I and age range were 25-80 years and mean age was 46 years in Group II. Squamous cell carcinoma were found (90%) and performance status was WHO grade 0-1 (>75%) in both groups. Local control of disease at 5 years was 65% in group I and 51% in group II. Overall survival at 2 years, 5 years, 7 years and 9 years in group I, was 71%, 64%, 55%, 46% and in group II, 54%,50%, 43%,32% respectively. Distant metastasis occurred in 22% in-group I and 28% in-group II. Lymph node, lung, liver, peritoneum were common site of metastasis. Proctitis, cystitis, vaginal stenosis in group I was 80%, 33% 16% and in Group II 29%, 13% and 5% respectively. Conclusion: External beam therapy and brachytherapy was effective treatment in carcinoma. Cervix in both operable and inoperable stages. In small volume of tumor, both schedules of radiotherapy were more or less equivalent but in bulky diseases Group I schedule that was higher dose by brachytherapy at point A showed better result; though the complication was more DOI: http://dx.doi.org/10.3329/bjog.v25i2.13739 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 50-58

scholarly journals Tumor volume as a prognostic factor for local control and overall survival in advanced larynx cancer

2015 ◽  
Vol 126 (2) ◽  
pp. E60-E67 ◽  
Author(s):  
Adriana J. Timmermans ◽  
Charlotte A. H. Lange ◽  
Josien A. de Bois ◽  
Erik van Werkhoven ◽  
Olga Hamming-Vrieze ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Local Control ◽  
Tumor Volume ◽  
Larynx Cancer
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