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Published on: March 18, 2020
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Advances in Organ Preservation for Laryngeal Cancer
Graham Campbell1, Tiffany A Glazer2, Randall J Kimple1,3
1Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Current Treatment Options in Oncology
|March 18, 2022
Summary
This study outlines head and neck cancer treatment protocols, emphasizing multidisciplinary care and individualized approaches like laryngectomy or laryngeal preservation. It details radiotherapy schedules and identifies key risk factors for weight loss during treatment.
Area of Science:
- Oncology
- Radiation Oncology
- Head and Neck Surgery
Background:
- Multidisciplinary tumor board review is standard for head and neck cancer patient care at the University of Wisconsin.
- Treatment decisions, including total laryngectomy versus laryngeal sparing approaches, are based on disease stage (T4), laryngeal function, and patient factors.
Purpose of the Study:
- To describe the University of Wisconsin's comprehensive treatment strategy for head and neck cancer.
- To identify risk factors for significant weight loss during treatment and outline prophylactic measures.
- To detail the follow-up schedule and criteria for considering salvage laryngectomy.
Main Methods:
- Patients undergo treatment planning via a multidisciplinary tumor board.
- Treatment modalities include total laryngectomy or laryngeal preservation, with radiotherapy (RT) as a primary component.
- Concurrent chemotherapy (cisplatin) or cetuximab is offered, with accelerated RT schedules for select patients.
- Prophylactic gastrostomy tubes are considered for patients with 2-3 identified risk factors for weight loss.
Main Results:
- Major risk factors for significant weight loss include prior weight loss (>10% in 6 months), concurrent cisplatin, and bilateral neck radiation.
- Prophylactic gastrostomy tubes are administered to patients with multiple risk factors.
- A structured follow-up protocol includes imaging (CT neck, PET-CT) and regular clinical visits for up to 7 years.
Conclusions:
- Individualized treatment planning is crucial for head and neck cancer patients.
- Risk stratification for weight loss allows for proactive interventions.
- Long-term surveillance is essential for monitoring treatment response and identifying potential progression requiring salvage surgery.
Keywords:
AryepiglotticArytenoidsCancerCetuximabCisplatinHead and neckHypopharynxImmunotherapyLaryngealLaryngectomyLarynxLocally advancedNivolumabPembrolizumabPharyngeal wallPostcricoidPreservationProtonPyriform sinusRadiationRadiotherapySBRTSquamous cell carcinomaSubglottisSupraglottisVocal cordsVocal foldsVoice
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