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Survival and Functional Outcome after Treatment for Primary Base of Tongue Cancer: A Comparison of Definitive Chemoradiotherapy versus Surgery Followed by Adjuvant Radiotherapy
Sangjoon Park, Yeona Cho, Jeongshim Lee, Yoon Woo Koh, Se-Heon Kim, Eun Chang Choi, Hye Ryun Kim, Ki Chang Keum, Kyung Ran Park, Chang Geol Lee
Cancer Res Treat. 2018;50(4):1214-1225.   Published online December 26, 2017
DOI: https://doi.org/10.4143/crt.2017.498
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to compare the clinical and functional outcomes in patients with primary base of tongue (BOT) cancer who received definitive radiotherapy (RT) or surgery followed by radiotherapy (SRT).
Materials and Methods
Between January 2002 andDecember 2016, 102 patientswith stage I-IVB primary BOT cancer underwent either definitive RT (n=46) or SRT (n=56), and treatment outcomeswere compared between two groups. The expression of p16 was also analyzed.
Results
The RT group had more patients with advanced T stage (T3-4) disease (58.7% vs. 35.7%, p=0.021) and who received chemotherapy (91.3% vs. 37.5%, p < 0.001) than the SRT group. At a median followup of 36.9 months (range, 3.3 to 181.5 months), the 5-year overall survival (OS) and disease-free survival (DFS) were 75.5% and 68.7%, respectively. With respect to treatment group, the 5-year OS and DFS in the RT and SRT groups did not differ significantly (OS, 68.7% vs. 80.5%, p=0.601; DFS, 63.1% vs. 73.1%, p=0.653). In multivariate analysis, OS differed significantly according to p16 expression (p16-negative vs. p16- positive; hazard ratio [HR], 0.145; 95% confidence interval [CI], 0.025 to 0.853; p=0.033). Regarding DFS, p16 expression (p16-negative vs. p16-positive; HR, 0.164; 95% CI, 0.045 to 0.598; p=0.006) showed a significant effect in multivariate analysis. Functional defects (late grade ≥ 3 dysphagia or voice alteration) were more frequently reported in the SRT than in the RT group (16.1% vs. 2.2%, p=0.021).
Conclusion
Despite advanced disease, patients in the RT group showed comparable survival outcomes and better functional preservation than those in the SRT group.

Citations

Citations to this article as recorded by  
  • Treatment de‐escalation for HPV+ oropharyngeal cancer: A systematic review and meta‐analysis
    Fausto Petrelli, Andrea Luciani, Antonio Ghidini, Sara Cherri, Paolo Gamba, Marta Maddalo, Paolo Bossi, Alberto Zaniboni
    Head & Neck.2022; 44(5): 1255.     CrossRef
  • Ginsenoside Rd inhibits migration and invasion of tongue cancer cells through H19/miR-675-5p/CDH1 axis
    Lu CHANG, Dongxu WANG, Shaoning KAN, Ming HAO, Huimin LIU, Zhijing YANG, Qianyun XIA, Weiwei LIU
    Journal of Applied Oral Science.2022;[Epub]     CrossRef
  • Postoperative Concurrent Chemoradiotherapy Versus Radiotherapy Alone for Advanced Oral Cavity Cancer in the Era of Modern Radiation Techniques
    Tae Hyung Kim, In-Ho Cha, Eun Chang Choi, Hye Ryun Kim, Hyung Jun Kim, Se-Heon Kim, Ki Chang Keum, Chang Geol Lee
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Superficial circumflex iliac artery perforator flap for tongue reconstruction after hemiglossectomy for cancer: A case report
    Hong Loi Nguyen, Truong Phu M. Ho, Xuan Phu Tran, Thanh Xuan Nguyen
    Oral and Maxillofacial Surgery Cases.2021; 7(2): 100219.     CrossRef
  • Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy
    Ambika Parmar, Michaelina Macluskey, Niall Mc Goldrick, David I Conway, Anne-Marie Glenny, Janet E Clarkson, Helen V Worthington, Kelvin KW Chan
    Cochrane Database of Systematic Reviews.2021;[Epub]     CrossRef
  • Larynx-preserving reconstruction after extended base of the tongue resection
    Hideki Kadota, Junichi Fukushima, Sei Yoshida, Kenichi Kamizono, Muneyuki Masuda, Satoshi Toh, Ryuji Yasumatsu, Torahiko Nakashima, Takashi Nakagawa
    Journal of Plastic, Reconstructive & Aesthetic Surgery.2020; 73(4): 740.     CrossRef
  • 9,829 View
  • 228 Download
  • 6 Web of Science
  • 6 Crossref
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Radiotherapy Versus Cordectomy in the Management of Early Glottic Cancer
Seung Yeun Chung, Kyung Hwan Kim, Ki Chang Keum, Yoon Woo Koh, Se-Heon Kim, Eun Chang Choi, Chang Geol Lee
Cancer Res Treat. 2018;50(1):156-163.   Published online March 17, 2017
DOI: https://doi.org/10.4143/crt.2016.503
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to compare the treatment outcomes of definitive radiotherapy (RT) with cordectomy in patients with early glottic cancer.
Materials and Methods
A total of 165 patientswhowere diagnosedwith T1/2 squamous cell carcinoma of the glottic larynx between January 2006 and December 2012 were retrospectively analyzed. A total of 112 patients received RT and 53 patients received cordectomy. Local control (LC), disease-free survival (DFS), overall survival (OS), and larynx preservation rates after RT and cordectomy were investigated.
Results
The median follow-up period was 77.7 months (range, 10.7 to 127.0 months). The 3- and 5-year LC rates were 91.9% and 89.9%, respectively, for the RT group, and 82.8% and 73.2%, respectively, for the cordectomy group (p=0.006). The 3- and 5-year DFS rates were 87.5% and 83.7%, respectively, for the RT group and 79.2% and 68.0%, respectively, for the cordectomy group (p=0.046). No significant differences were identified in the 5-year OS (92.8% vs. 90.6%, p=0.713) or larynx preservation rates (98.2% vs. 97.2%, p=0.831) between groups. The major failure pattern was local failure (n=26), followed by regional (n=3) and distant failure (n=2). Multivariate analysis of LC showed that T2 stage (p=0.012) and receiving cordectomy as initial treatment (p=0.001) were significantly associated with poorer LC.
Conclusion
RT resulted in higher rates of LC and DFS compared to cordectomy for early glottic cancer. Treatment with radiotherapy is feasible and should be encouraged for both T1 and T2 glottic cancer.

Citations

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    Practica oto-rhino-laryngologica. Suppl..2023; 163: 89.     CrossRef
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    Qi-wei Liang, Liang Peng, Jing Liao, Chun-xia Huang, Wei-ping Wen, Wei Sun
    Frontiers in Surgery.2022;[Epub]     CrossRef
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    Meltem Dağdelen, Merve Şahin, Tuba Kurt Çatal, Halil Cumhur Yıldırım, Songül Çavdar Karaçam, Kimia Çepni, Ömer Erol Uzel
    Strahlentherapie und Onkologie.2022; 198(11): 1025.     CrossRef
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    Min-Su Kim, Hong-Gyun Wu, Myung-Whun Sung, Tack-Kyun Kwon
    Acta Otorhinolaryngologica Italica.2022; 42(6): 525.     CrossRef
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    Petros D. Karkos, Ioannis Koskinas, Marios Stavrakas, Stefanos Triaridis, Jannis Constantinidis
    Ear, Nose & Throat Journal.2021; 100(1_suppl): 19S.     CrossRef
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    Ruichen Li, Qi Wang, Li Yan, Yi Zhu, Shengzi Wang, Shu Tian
    Oral Oncology.2021; 116: 105230.     CrossRef
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    Head & Neck.2020; 42(5): 854.     CrossRef
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Tumor Stage-Related Role of Radiotherapy in Patients with an External Auditory Canal and Middle Ear Carcinoma
Jinhyun Choi, Se-Heon Kim, Yoon Woo Koh, Eun Chang Choi, Chang Geol Lee, Ki Chang Keum
Cancer Res Treat. 2017;49(1):178-184.   Published online July 4, 2016
DOI: https://doi.org/10.4143/crt.2016.165
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to evaluate the clinical outcomes of patients treated with radiotherapy (RT) for a carcinoma of the external auditory canal (EAC) and middle ear.
Materials and Methods
The records of 32 patients who received RT from 1990 to 2013 were reviewed retrospectively. The Pittsburgh classification was used to stage all the cancers (early stage, T1/T2 [n=12]; advanced stage, T3/T4 or N positive [n=20]). Twenty-one patients (65.6%) were treated with postoperative RT and 11 patients (34.4%) were treated with definitive RT. The median radiation doses for postoperative and definitive RT were 60 Gy and 64.8 Gy, respectively. Chemotherapy was administered to seven patients (21.9%).
Results
The 5-year overall survival and disease-free survival rates for all patients were 57% and 52%, respectively. The disease control rates for the patients with early stage versus advanced stage carcinomawere 55.6% (5/9) and 50% (6/12) in the postoperative RT group and 66.7% (2/3) and 37.5% (3/8) in the definitive RT group, respectively. Overall, 15 cases (14 patients, 46.7%) experienced treatment failure; these failures were classified as local in four cases, regional in one case, and distant in 10 cases. The median follow-up period after RT was 51 months (range, 7 to 286 months).
Conclusion
Patients with early stage carcinoma achieved better outcomes when definitive RT was used. Advanced stage carcinoma patients experienced better outcomes with postoperative RT. The high rate of distant failure after RT, with or without surgery, reflected the lack of a consensus regarding the best therapeutic approach for treating carcinoma of the EAC and middle ear.

Citations

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Definitive Chemoradiotherapy Versus Surgery Followed by Adjuvant Radiotherapy in Resectable Stage III/IV Hypopharyngeal Cancer
Jun Won Kim, Mi Sun Kim, Se-Heon Kim, Joo Hang Kim, Chang Geol Lee, Gwi Eon Kim, Ki Chang Keum
Cancer Res Treat. 2016;48(1):45-53.   Published online March 13, 2015
DOI: https://doi.org/10.4143/crt.2014.340
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to compare the treatment outcomes for locally advanced resectable hypopharyngeal cancer between organ-preserving chemoradiotherapy (CRT) and surgery followed by radiotherapy (SRT).
Materials and Methods
We reviewed 91 patients with stage III/IV hypopharyngeal squamous cell carcinoma treated with radiotherapy (RT). In the CRT group (n=34), 18 patients were treated with concurrent CRT and 16 patients with induction chemotherapy plus concurrent CRT. In the SRT group (n=57), six patients were treated with total laryngopharyngectomy, 34 patients with total laryngectomy (TL) and partial pharyngectomy (PP), and 17 patients with PP, which were followed by adjuvant radiotherapy (n=41) or CRT (n=16). The median RT dose was 70 Gy for CRT and 59.4 Gy for SRT.
Results
Five-year local control (84.1% vs. 90.9%), and disease-free survival (DFS, 51.0% vs. 52.7%) and overall survival (OS, 58.6% vs. 56.6%) showed no significant difference between the CRT and SRT groups. The functional larynx-preservation rate was higher in the CRT group (88.2% vs. 29.8%). Treatment-related toxicity, requiring surgical intervention, occurred more frequently in the SRT group (37% vs. 12%). In the SRT group, TL resulted in a significantly higher DFS than larynx-sparing surgery (63.9% vs. 26.5%, p=0.027). Treatment outcome of the SRT group improved when only patients with TL were considered (n=40); however, 5-year OS (67.1% vs. 58.6%, p=0.830) and DFS (63.9% vs. 51.0%, p=0.490) did not improve significantly when compared to the CRT group.
Conclusion
Organ preserving CRT provided a treatment outcome that is comparable to SRT for locally advanced hypopharyngeal cancer, while offering an opportunity for functional larynx-preservation and reduced treatment-related toxicity.

Citations

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