1Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
2Department of Radiation Oncology, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
3Department of Otorhinolaryngology, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
4Department of Medical Oncology, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea
Copyright © 2016 by the Korean Cancer Association
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Characteristic | Total (n=91) | SRT (n=57) | CRT (n=34) | p-value | |
---|---|---|---|---|---|
Median age (range, yr) | 64 (36-80) | 64 (39-81) | 65.5 (37-81) | ||
Sex | Male | 86 (94.5) | 56 (98.2) | 30 (88.2) | 0.043 |
Female | 5 (5.5) | 1 (1.8) | 4 (11.8) | ||
Subsite | PS | 73 (80.2) | 48 (84.2) | 25 (73.5) | 0.401 |
PW | 13 (14.3) | 6 (10.5) | 7 (20.6) | ||
PC | 5 (5.5) | 3 (5.3) | 2 (5.9) | ||
cT stage | cT1 | 8 (8.8) | 6 (10.5) | 2 (5.9) | 0.342 |
cT2 | 26 (28.6) | 17 (29.8) | 9 (26.5) | ||
cT3 | 27 (29.7) | 19 (33.3) | 8 (23.5) | ||
cT4a | 30 (33.0) | 15 (26.3) | 15 (44.1) | ||
cN stage | cN0 | 12 (13.2) | 6 (10.5) | 6 (17.6) | 0.618 |
cN1 | 14 (15.4) | 8 (14.0) | 6 (17.6) | ||
cN2 | 60 (65.9) | 39 (68.4) | 21 (61.8) | ||
cN3 | 5 (5.5) | 4 (7.0) | 1 (2.9) | ||
Stage | III | 17 (18.7) | 11 (19.3) | 6 (17.6) | 0.629 |
IV a | 68 (74.7) | 42 (73.7) | 27 (79.4) | ||
IV b | 6 (6.6) | 4 (7.0) | 1 (2.9) | ||
RT | 3DCRT | 73 (80.2) | 51 (89.5) | 22 (64.7) | 0.004 |
IMRT | 18 (19.8) | 6 (10.5) | 12 (35.3) |
Variable | No. of patients (%) | DFS |
OS |
||||
---|---|---|---|---|---|---|---|
5-Yr DFS (%) | 95% CI | p-value | 5-Yr OS (%) | 95% CI | p-value | ||
Age (yr) | |||||||
≤ 60 | 36 (40) | 56.9 | 40.2-73.6 | 0.076 | 62.7 | 46.4-79.0 | 0.049 |
> 60 | 55 (60) | 49.1 | 35.4-62.8 | 54.2 | 40.5-67.9 | ||
Sex | |||||||
Female | 5 (6) | 80.0 | 44.9-115.1 | 0.396 | 75.0 | 32.5-117.5 | 0.260 |
Male | 86 (94) | 50.3 | 39.3-61.3 | 55.0 | 44.0-66.0 | ||
Subsite | |||||||
PS | 73 (80) | 54.5 | 42.7-66.3 | 0.606 | 60.2 | 48.6-71.8 | 0.887 |
PW/PC | 18 (20) | 42.9 | 19.2-66.6 | 46.2 | 21.5-70.9 | ||
T stage | |||||||
T1-2 | 34 (37) | 57.8 | 40.7-74.9 | 0.539 | 60.0 | 42.9-77.1 | 0.641 |
T3-4 | 57 (63) | 48.8 | 35.3-62.3 | 56.2 | 42.7-69.7 | ||
N stage | |||||||
N0-1 | 26 (29) | 52.6 | 33.0-72.2 | 0.652 | 59.3 | 39.5-79.1 | 0.517 |
N2-3 | 65 (71) | 51.9 | 39.2-64.6 | 56.6 | 44.1-69.1 | ||
Treatment | |||||||
SRT | 57 (63) | 52.7 | 39.4-66.0 | 0.991 | 56.6 | 43.5-69.7 | 0.713 |
CRT | 34 (37) | 51.0 | 33.4-68.6 | 58.6 | 41.0-76.2 | ||
RT | |||||||
IMRT | 18 (20) | 35.7 | 12.2-59.2 | 0.116 | 53.6 | 27.1-80.0 | 0.873 |
3DCRT | 73 (80) | 56.3 | 44.5-68.1 | 57.9 | 46.3-69.5 |
Patient No. | Age (yr)/Sex | Subsite | Stage | Treatment | Failure pattern | Stage at failure | Salvage treatment | Salvage response | Current status | Survival after recurrence (mo) |
---|---|---|---|---|---|---|---|---|---|---|
1 | 70/M | PS | pT1N2c | P/P+RT | R & D | N2cM1 | CTx | PD | DOD | 1 |
2 | 63/M | PW | pT2N2c | P/P+RT | R | N1 (CA invas) | None | n/a | DOD | 9 |
3 | 50/M | PS | pT4aN0 | P/P+RT | L | T4aN0 | Excision | PD | DOD | 10 |
4 | 65/M | PW | pT2N2b | P/P+RT | L & R | T3N1 | None (conservative) | n/a | DOD | 2 |
5 | 73/M | PW | pT3N1 | P/P+RT | L & D | T4aN0M1 | CTx | PD | DOD | 4 |
6 | 54/M | PW | pT2N2b | P/P+RT | L | T3N0 | CCRT | CR | AWOD | 24 |
7 | 55/M | PS | pT4aN2c | T/L+CCRT | R | N1 | None (refused) | n/a | DOD | 4 |
8 | 47/M | PS | pT4aN2c | T/L+RT | R | N2b | CCRT | PD | DOD | 10 |
9 | 65/M | PS | pT4aN3 | T/L+CCRT | L & R | T4aN2b | CTx | PD | DOD | 4 |
10 | 63/M | PS | pT4aN2b | T/L+RT | R | N2c | CTx | PD | DOD | 7 |
11 | 72/M | PS | pT2N1 | T/L+CCRT | L & R | T4aN2c | CCRT | PD | DOD | 4 |
12 | 54/M | PS | pT4aN1 | T/L+RT | R | N2c | Neck dissection | NED | AWOD | 7 |
13 | 57/M | PS | pT4aN2b | T/L+CCRT | L | T4aN0 | CTx | PD | DOD | 5 |
14 | 66/M | PS | cT3N0 | Induction+CCRT | L | T4a | None | n/a | DOD | 0 |
15 | 66/M | PS | cT4aN2b | Induction+CCRT | R | N2b | Neck dissection | PD | DOD | 9 |
16 | 77/M | PS | cT4aN2b | Induction+CCRT | L | T4N0 | Transoral P/P | NED | DOOC | 4 |
17 | 63/M | PS | cT1N2b | Induction+CCRT | R | N1 (CA invas) | Neck dissection | NED | DOOC | 17 |
18 | 40/M | PC | cT4aN0 | CCRT | L | T4a | TLP | NED | DOOC | 23 |
19 | 68/M | PS | cT3N1 | CCRT | L | T4aN0 | TL/PP | NED | AWOD | 48 |
20 | 66/M | PS | cT4aN0 | CCRT | L | T4aN0 | TL/PP | NED | AWOD | 45 |
21 | 57/F | PC | cT2N2c | CCRT | R | N2b | Neck dissection | NED | AWOD | 5 |
Variable | SRT (n=57) | CRT (n=34) |
---|---|---|
Wound infection | 4 (7) | 1 (3) |
Flap failure | 4 (7) | 0 |
Esophageal/pharyngeal stenosis | 8 (14) | 2 (6) |
Pharyngocutaneous fistula | 1 (2) | 0 |
Stoma stenosis | 4 (7) | 1 (3) |
Variable | CTCAE grade | SRT (n=57) | CRT (n=34) |
---|---|---|---|
Voice alteration | 2 | 3 | 1 |
3 | 1 | 1 | |
4 | 40 (40) |
3 (3) |
|
Dysphagia | 2 | 35 (33) |
7 |
3 | 9 (7) | 4 | |
4 | 0 | 1 (1) |
Values are presented as number (%) unless otherwise indicated. SRT, surgery plus radiotherapy; CRT, chemoradiotherapy; PS, pyriform sinus; PW, pharyngeal wall; PC, postcricoid; cT, clinical T stage; 3DCRT, 3D conformal radiotherapy; IMRT, intensity-modulated radiotherapy.
DFS, disease-free survival; OS, overall survival; CI, confidence interval; PS, pyriform sinus; PW, pharyngeal wall; PC, postcricoid; SRT, surgery plus radiotherapy; CRT, chemoradiotherapy; RT, radiotherapy; IMRT, intensity modulated radiotherapy; 3DCRT, 3 dimensional conformal radiotherapy.
PS, pyriform sinus; P/P, partial pharyngectomy; RT, radiotherpy; R, regional; D, distant; CTx, chemotherapy; PD, progression of disease; DOD, died of disease; PW, pharyngeal wall; CA, carotid artery; n/a, not available; L, local; CCRT, concurrent chemoradiotherapy; CR, complete remission; AWOD, alive without disease; T/L, total laryngectomy; NED, no evidence of disease; TLP, total laryngopharyngectomy; DOOC, died of other cause; PC, postcricoid; TL/PP, total laryngectomy & partial pharyngectomy.
Values are presented as number (%). SRT, surgery plus radiotherapy; CRT, chemoradiotherapy.
CTCAE, Common Terminology Criteria for Adverse Events; SRT, surgery plus radiotherapy; CRT, chemoradiotherapy. Numbers in parenthesis are due to total laryngectomy or salvage surgery.