Changes in treatment of advanced laryngeal cancer 1985-2001.

Abstract

OBJECTIVE:

In 1991, a randomized study was published and demonstrated that use of nonsurgical therapy (chemoradiation) provided similar survival to total laryngectomy (the gold standard) for patients with advanced-stage laryngeal cancer. The purpose of this study was to assess how treatment of advanced laryngeal cancer was influenced by such developments in non-surgical therapy.

STUDY DESIGN:

Patterns of care study using National Cancer Database (1985-2001).

RESULTS:

The percentage of advanced-stage patients treated with chemoradiation increased from 8.3% to 20.8% while the proportion treated with radiation alone decreased from 38.9% to 23.0%. Use of chemoradiation increased at a significantly faster rate after the 1991 publication at both community cancer centers and teaching research facilities. The use of total laryngectomy decreased slightly during this period.

CONCLUSIONS:

The use of chemoradiation increased after the 1991 publication. It was impossible to determine from the NCDB whether additional patients who could benefit from chemo-RT were not offered or did not complete this treatment option. We recommend that treatment recommendations discussed at tumor boards be recorded in cancer registries.

• Authors: Amy Y Chen, Nicole Schrag, Yongping Hao, W Dana Flanders, James Kepner, Andrew Stewart, Elizabeth Ward
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 135 Issue 6 Pg. 831-7 (Dec 2006) ISSN: 0194-5998 [Print] England
• PMID: 17141069 (Publication Type: Comparative Study, Journal Article, Meta-Analysis)

Chemical References

• Antineoplastic Agents

Topics

• Aged
• Antineoplastic Agents (therapeutic use)
• Cancer Care Facilities (statistics & numerical data)
• Combined Modality Therapy
• Female
• Hospitals, Community (statistics & numerical data)
• Hospitals, Teaching (statistics & numerical data)
• Humans
• Laryngeal Neoplasms (drug therapy, radiotherapy)
• Laryngectomy (statistics & numerical data, trends)
• Male
• Medical Oncology (trends)
• Middle Aged
• United States