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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 3/2021

Open Access 01-03-2021 | Laryngoscopy | Review Article

Routine restaging after primary non-surgical treatment of laryngeal squamous cell carcinoma—a review

Authors: Caroline Theresa Seebauer, Berit Hackenberg, Jirka Grosse, Janine Rennert, Ernst-Michael Jung, Ines Ugele, Ioannis Michaelides, Hisham Mehanna, Matthias G. Hautmann, Christopher Bohr, Julian Künzel

Published in: Strahlentherapie und Onkologie | Issue 3/2021

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Abstract

Purpose

Treatment of patients with laryngeal squamous cell carcinoma with radiotherapy or chemoradiation is an established alternative to laryngeal surgery in many cases, but particularly for advanced tumors without cartilage invasion. Imaging modalities face the challenge of distinguishing between posttherapeutic changes and residual disease in the complex anatomic subsite of the larynx. Guidelines concerning restaging of head and neck squamous cell carcinomas (HNSCC) are presented by the National Comprehensive Cancer Network (NCCN) and other national guidelines, but clearly defined recommendations for routine restaging particularly for laryngeal cancer are lacking.

Methods

A systematic search was carried out in PubMed to identify studies evaluating routine restaging methods after primary non-surgical treatment of laryngeal squamous cell carcinoma from 2009 to 2020.

Results

Only three studies were deemed eligible, as they included at least ≥50% patients with laryngeal squamous cell carcinoma and evaluated imaging modalities to detect residual cancer. The small number of studies in our review suggest restaging with fluoro-deoxy-glucose positron-emission tomography/computed tomography (FDG PET/CT) 3 months after initial treatment, followed by direct laryngoscopy with biopsy of the lesions identified by FDG PET/CT.

Conclusion

Studies evaluating restaging methods after organ-preserving non-surgical treatment of laryngeal carcinoma are limited. As radiotherapy (RT), chemoradiotherapy (CRT), systemic therapy followed by RT and radioimmunotherapy are established alternatives to surgical treatment, particularly in advanced laryngeal cancers, further studies are needed to assess and compare different imaging modalities (e.g. PET/CT, MRI, CT, ultrasound) and clinical diagnostic tools (e.g., video laryngoscopy, direct laryngoscopy) to offer patients safe and efficient restaging strategies. PET or PET/CT 3 months after initial treatment followed by direct laryngoscopy with biopsy of the identified lesions has the potential to reduce the number of unnecessary laryngoscopies.
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Metadata
Title
Routine restaging after primary non-surgical treatment of laryngeal squamous cell carcinoma—a review
Authors
Caroline Theresa Seebauer
Berit Hackenberg
Jirka Grosse
Janine Rennert
Ernst-Michael Jung
Ines Ugele
Ioannis Michaelides
Hisham Mehanna
Matthias G. Hautmann
Christopher Bohr
Julian Künzel
Publication date
01-03-2021
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 3/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-020-01706-9

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