Tumour volume: implications in T2/T3 glottic/supraglottic squamous cell carcinoma

Area of Science:

• Oncology
• Radiotherapy
• Surgical Oncology

Background:

• Locoregional control is crucial for laryngeal carcinoma treatment outcomes.
• Pretreatment tumor volume may offer predictive value for treatment response.

Purpose of the Study:

• To investigate if tumor volume predicts locoregional control in T2/T3 glottic/supraglottic laryngeal carcinoma treated with radiotherapy or surgery.
• To assess the impact of radiotherapy dosage on treatment outcomes.
• To identify patients suitable for primary radiotherapy based on pretreatment imaging for potential voice preservation.

Main Methods:

• Retrospective review of 55 patients with untreated T2/T3 laryngeal squamous cell carcinoma (SCC).
• Tumor volume calculated from pretreatment CT scans.
• Statistical analysis using Wilcoxon t test and Cox regression.

Main Results:

• Mean tumor volume was significantly larger in surgically treated patients (11 cm3) compared to radiotherapy-treated patients (4.5 cm3).
• In the primary radiotherapy group, mean tumor volume differed between T2 (3.8 cm3) and T3 (9.3 cm3) tumors.
• Tumor volume > 4.0 cm3 predicted local failure in T2 laryngeal tumors treated with radiotherapy, irrespective of radiation dose.

Conclusions:

• Tumor volume exceeding 4 cm3 is a significant predictor of local failure in T2 laryngeal tumors treated with radiotherapy.
• This volume-based prediction of failure was not observed in T3 tumors treated with radiotherapy or in tumors treated surgically.
• Tumor volume data could potentially enhance current laryngeal carcinoma classification systems.