Clinical analysis of EBRT vs TLM in the treatment of early (T1-T2N0) glottic laryngeal cancer

Shen, Jing; Hu, Ke; Ma, Jiabin; Zhen, Hongnan; Guan, Hui; Wang, Wenhui; Zhang, Fuquan

doi:10.7150/jca.46487

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J Cancer 2020; 11(22):6686-6694. doi:10.7150/jca.46487 This issue Cite

Research Paper

Clinical analysis of EBRT vs TLM in the treatment of early (T1-T2N0) glottic laryngeal cancer

Jing Shen, Ke Hu^✉, Jiabin Ma, Hongnan Zhen, Hui Guan, Wenhui Wang, Fuquan Zhang

Chinese Academy of Medical Sciences & Peking Union Medical College, NO.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing 100730, People's Republic of China

Citation:

Shen J, Hu K, Ma J, Zhen H, Guan H, Wang W, Zhang F. Clinical analysis of EBRT vs TLM in the treatment of early (T1-T2N0) glottic laryngeal cancer. J Cancer 2020; 11(22):6686-6694. doi:10.7150/jca.46487. https://www.jcancer.org/v11p6686.htm

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Abstract

Objective: To analyze the clinical efficacy of external beam radiation therapy (EBRT) vs transoral laser microsurgery (TLM) in patients with early glottic laryngeal carcinoma (T1-T2N0) and the effect of treatment choice on vocal function.

Methods: A retrospective analysis of patients with T1-T2N0 glottic laryngeal carcinoma who underwent EBRT or TLM between January 2012 and December 2018 in PUMCH. The Kaplan-Meier method was used to analyze local control, progression-free survival and overall survival, and the VHI-30 scale was used to evaluate the effects of EBRT and TLM on vocal function.

Results: A total of 185 patients, all with pathologically confirmed squamous cell carcinoma, were enrolled. The median age was 62 years (38-88). N0 disease was confirmed by imaging: 142/185 (76.76%) patients had T1N0 disease, and 43/185 patients (23.24%) had T2/N0 disease. A total of 91/195 (49.19%) patients received an EBRT dose of 66-70 Gy/30-35f, at 2.0-2.3 Gy/f. 94/185 (50.81%) patients received TLM. The median follow-up time was 42 months (12-92), and the 3-year LC, PFS, and OS rates for the EBRT and TLM groups were 96.9% vs 94.1%(p=0.750), 95.3% vs 93.1%(p=0.993) and 93.3% vs 95.4%(p=0.467), respectively. The VHI-30 scales were used at the baseline showed no significant difference between the two groups 19.20±3.324 vs 21.65±9.80 (p=0.250), but the EBRT group had a low voice handicap after treatment, 10.24±6.093 vs 19.45±5.112 (p=0.001) (6 months) and 9.45±5.112 vs 14.97±7.741 (12 months). No CTCAE grade 3 or above side effects were observed in the EBRT group, but 3 cases of vocal cord stenosis were observed in the TLM group.

Conclusion: The application of EBRT for early glottic laryngeal carcinoma (T1-T2N0) had an obvious curative effect with high LC and OS rates, no serious side effects, and a low voice handicap rate.

Keywords: glottic laryngeal cancer, external beam radiation therapy, transoral laser microsurgery, voice outcome, VHI

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APA

Shen, J., Hu, K., Ma, J., Zhen, H., Guan, H., Wang, W., Zhang, F. (2020). Clinical analysis of EBRT vs TLM in the treatment of early (T1-T2N0) glottic laryngeal cancer. Journal of Cancer, 11(22), 6686-6694. https://doi.org/10.7150/jca.46487.

ACS

Shen, J.; Hu, K.; Ma, J.; Zhen, H.; Guan, H.; Wang, W.; Zhang, F. Clinical analysis of EBRT vs TLM in the treatment of early (T1-T2N0) glottic laryngeal cancer. J. Cancer 2020, 11 (22), 6686-6694. DOI: 10.7150/jca.46487.

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CSE

Shen J, Hu K, Ma J, Zhen H, Guan H, Wang W, Zhang F. 2020. Clinical analysis of EBRT vs TLM in the treatment of early (T1-T2N0) glottic laryngeal cancer. J Cancer. 11(22):6686-6694.

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