Retrospective analysis: concurrent chemoradiotherapy and adjuvant chemotherapy for T2N0 glottic squamous cell...

This study aimed to evaluate the efficacy and toxicity of concurrent chemoradiotherapy and adjuvant chemotherapy for T2N0 glottic squamous cell carcinoma. Between May 1993 and March 2004, 32 patients with T2N0 glottic squamous cell carcinoma received concurrent chemoradiotherapy as the primary treatment modality for larynx preservation. Radiotherapy was delivered five days a week using a once-daily fractionation of 2.0 Gy (median total dose: 70 Gy). The chemotherapy regimen comprised carboplatin in 4 patients, carboplatin and tegafur and uracil in 7, carboplatin and futraful in 2, and futraful in 19 patients. Twenty-four patients received adjuvant chemotherapy with tegafur and uracil. Initial local tumor control was achieved in 30 patients (94%). The 5-year overall survival and 5-year local control rates were 97% and 70%, respectively. Univariate analysis revealed adjuvant chemotherapy as a significant prognostic factor for the local control rate (P = 0.038). The 5-year local control rate in patients treated or not treated with adjuvant chemotherapy was 82% and 42%, respectively. No significant differences in the local control rate were noted in overall treatment time, total radiation dose, age, and disease extension to the subglottis. With regard to adverse reactions, grade 3 neutropenia and grade 3 hepatotoxicity were observed in 1 and 2 patients, respectively. We observed no severe late complications (RTOG/EORTC criteria Grade 3-4) related to this combination therapy. Concurrent chemoradiotherapy and adjuvant chemotherapy was effective but with mild toxicity, and adjuvant chemotherapy significantly improved local control. We suggest the use of this combination therapy for achieving a local control of T2N0 glottic squamous cell carcinoma.