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 New antibody analysis accelerates rational vaccine design
09.08.2018 | Scripps Research Institute

nachricht Distrust of power influences choice of medical procedures
01.08.2018 | Johannes Gutenberg-Universität Mainz

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: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

Im Focus: Lining up surprising behaviors of superconductor with one of the world's strongest magnets

Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur

What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...

Im Focus: World record: Fastest 3-D tomographic images at BESSY II

The quality of materials often depends on the manufacturing process. In casting and welding, for example, the rate at which melts solidify and the resulting microstructure of the alloy is important. With metallic foams as well, it depends on exactly how the foaming process takes place. To understand these processes fully requires fast sensing capability. The fastest 3D tomographic images to date have now been achieved at the BESSY II X-ray source operated by the Helmholtz-Zentrum Berlin.

Dr. Francisco Garcia-Moreno and his team have designed a turntable that rotates ultra-stably about its axis at a constant rotational speed. This really depends...

Im Focus: A molecular switch may serve as new target point for cancer and diabetes therapies

If certain signaling cascades are misregulated, diseases like cancer, obesity and diabetes may occur. A mechanism recently discovered by scientists at the Leibniz- Forschungsinstitut für Molekulare Pharmakologie (FMP) in Berlin and at the University of Geneva has a crucial influence on such signaling cascades and may be an important key for the future development of therapies against these diseases. The results of the study have just been published in the prestigious scientific journal 'Molecular Cell'.

Cell growth and cell differentiation as well as the release and efficacy of hormones such as insulin depend on the presence of lipids. Lipids are small...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

2018 Work Research Conference

25.07.2018 | Event News

 
Latest News

NRL's sun imaging telescopes fly on NASA Parker Solar Probe

13.08.2018 | Physics and Astronomy

UT-ORNL team makes first particle accelerator beam measurement in six dimensions

13.08.2018 | Physics and Astronomy

ASU astrophysicist helps discover that ultrahot planets have starlike atmospheres

13.08.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>