Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Chemo-radiation Offers Better Post-treatment Voice Quality for Laryngeal Cancer

10.08.2004


Researchers find that laryngeal cancer patients treated with chemo-radiation have a similar survival rate and better speech after treatment than those who had their voice box removed.

This finding could be important for the 10,000 patients who will be diagnosed with laryngeal cancer in 2004. Many treatment options exist: surgery, radiation, chemotherapy, chemo-radiotherapy (chemo-radiation), or a combination thereof. Depending on the extent of disease, surgery may involve removal of the entire larynx, a permanent tracheostoma (a hole in the neck that allows the patient to breathe), and vocal impairment. Preservation of the larynx and voice is important, but becomes more difficult in the advanced stages of disease.

Non-surgical treatment options such as chemo-radiation can often preserve the laryngeal structure. Chemo-radiation and other non-surgical techniques are known to cause destruction of tissue surrounding the cancer site, possibly rendering the organ dysfunctional. The present study is the first to ask the question: Is the voice box worth preserving after chemo-radiation treatment?



This question may be answered in the study, ¡°Voice and swallowing outcomes of an organ preservation trial for advanced laryngeal cancer¡± to be presented by study authors Kevin Fung, MD, Teresa Lyden, MA, Julia Lee, MS, MPH, Susan G. Urba, MD, Frank Worden, MD, Avraham Eisbruch, MD, Christina Tsien, MD, Carol R. Bradford, MD, Douglas B. Chepeha, MD, Norman D. Hogikyan, MD, Mark E. P. Prince, MD, Theodoros N. Teknos, MD, Gregory T. Wolf, MD, Head and Neck Oncology Program, all of the Department of Otolaryngology ¨C Head & Neck Surgery, University of Michigan, Ann Arbor, MI, at the 6th International Conference on Head and Neck Cancer being held August 7-11, 2004, at the Marriott Wardman Park in Washington, DC.

Methodology: A prospective phase II clinical trial was conducted in 97 patients with advanced squamous cell carcinoma of the larynx or hypopharynx (Stage III and IV) that was previously untreated, surgically resectable, and curable with conventional surgery and radiotherapy.

All patients were given a single course of induction chemotherapy followed by assessment of response by direct laryngoscopy. Patients who achieved <50 percent response underwent early salvage laryngectomy, and patients who achieved ¡Ý50 percent response underwent concurrent chemo-radiation followed by adjuvant chemotherapy. Assessments were made by direct laryngoscopy and biopsy; late salvage surgery was performed on patients with persistent or recurrent disease. Survey data was obtained from patients who were alive and free of disease. Voice and swallowing function was measured using validated quality of life instruments (Voice-Related Quality of Life Measure ¨C V-RQOL, and Performance Status Scale for Head and Neck Cancer Patients ¨C PSS-HN), and nutritional mode: (i) Nothing by mouth, (ii) Tube feeds, trial oral intake, (iii) Combined oral and tube feeds, (iv) Nutritional supplements only taken by mouth, (v) Oral intake with nutritional supplements, and (vi) Oral intake alone; no supplements.

Results: Completed V-RQOL survey data were obtained from 56 patients who were alive and free of disease at the time of survey. Completed PSS-HN data were available from 41 of 56 patients. In this cohort, partial (¡Ý50 percent) response after induction chemotherapy was achieved in 78.6 percent of patients. Overall, organ preservation was achieved in 66.1 percent of patients. Laryngectomy was performed on 19 patients (33.9 percent), of which 12 (63.2 percent) were done after induction chemotherapy (early) and seven (36.8 percent) were done after persistent or recurrent disease (late). The overall three-year survival rate was 86 percent.

V-RQOL scores in the study patients were lower compared to normal patients, but higher compared to patients who had had their larynx removed. No differences were detected between patients grouped by early and late laryngectomy. Significant predictors of higher total V-RQOL scores are lower cancer stage, organ preservation, and length of time since treatment. Speech scores were lower in those without a voice box, but eating in public and normalcy of diet were similar for both groups.

Conclusion: Voice-related quality of life is better in larynx cancer patients who are treated with chemo-radiation therapy than those who have their voice box removed. These findings indicate that a chemo-radiated voice box is worth preserving. However, longer follow-up of larynx preservation patients is needed to evaluated late toxicity and organ function since fibrosis after aggressive radiation regimes increases over time.

| newswise
Further information:
http://www.sic2004.org

More articles from Health and Medicine:

nachricht A promising target for kidney fibrosis
21.04.2017 | Brigham and Women's Hospital

nachricht Stem cell transplants: activating signal paths may protect from graft-versus-host disease
20.04.2017 | Technische Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

DGIST develops 20 times faster biosensor

24.04.2017 | Physics and Astronomy

Nanoimprinted hyperlens array: Paving the way for practical super-resolution imaging

24.04.2017 | Materials Sciences

Atomic-level motion may drive bacteria's ability to evade immune system defenses

24.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>