Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 3/2024

29-12-2023 | Radiotherapy | Head and Neck

Chemoradiotherapy vs radiotherapy for non-surgical locally advanced laryngeal squamous cell carcinoma patients: a propensity score-matched study and practical nomogram construction

Authors: Yuan Zhang, Zhipeng Wang, Yun Zheng

Published in: European Archives of Oto-Rhino-Laryngology | Issue 3/2024

Login to get access

Abstract

Objective

To compare the cancer-specific survival (CSS) among patients with locally advanced laryngeal squamous cell carcinoma (LSCC) receiving chemoradiotherapy (CRT) and radiotherapy (RT) treatment, as well as to establish a prognostic nomogram for survival prediction in patients receiving CRT.

Method

Using data from the Surveillance, Epidemiology, and End Results (SEER) database, patients with laryngeal cancer were identified between 2010 and 2015, with follow-up up to 2018. Propensity score matching (PSM) was performed to minimize disproportionate distributions of the potential confounding. Cox regression models were used to evaluate the CSS of two treatment groups. A prognostic nomogram for patients receiving CRT was then developed and evaluated.

Results

Totally 1085 non-surgical patients with locally advanced LSCC were included in this study (median [IQR] age, 62 [55–69] years; 829 [76.41%] males), of which 913 receiving CRT and 172 receiving RT. After PSM, significantly improved CSS was observed in locally advanced LSCC patients receiving CRT when compared to RT (HR: 0.62 [95% CI 0.42–0.92]; P = 0.014). Then, in the group of 639 locally advanced LSCC patients receiving CRT, a prognostic nomogram based on age, tumor size, N category, and marital status were developed and validated, of which the predictive performance was superior to that of TNM staging system (7th edition).

Conclusion

CSS shows a statistically significant improvement in locally advanced LSCC patients who receipt of CRT when compared with RT. Furthermore, a prognostic nomogram for locally advanced LSCC patients receiving CRT was established, which shows a good calibration and identification accuracy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics. Cancer J Clin 65(2):87–108CrossRef Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics. Cancer J Clin 65(2):87–108CrossRef
2.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424CrossRefPubMed Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424CrossRefPubMed
3.
go back to reference Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF (2017) An update on larynx cancer. Cancer J Clin 67(1):31–50CrossRef Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF (2017) An update on larynx cancer. Cancer J Clin 67(1):31–50CrossRef
4.
go back to reference Randa O, Magi R, Chafeek T (2019) The treatment of laryngeal cancer. Oral Maxillofac Surg Clin N Am 31(1):1–11CrossRef Randa O, Magi R, Chafeek T (2019) The treatment of laryngeal cancer. Oral Maxillofac Surg Clin N Am 31(1):1–11CrossRef
5.
go back to reference Pfister DG, Laurie SA, Weinstein GS (2006) American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 24:3693–3704CrossRefPubMed Pfister DG, Laurie SA, Weinstein GS (2006) American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 24:3693–3704CrossRefPubMed
6.
go back to reference Wolf GT, Fisher SG, Hong WK, Hillman R, Spaulding M, Laramore GE (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324:1685–1690CrossRefPubMed Wolf GT, Fisher SG, Hong WK, Hillman R, Spaulding M, Laramore GE (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324:1685–1690CrossRefPubMed
7.
go back to reference Karlsson TR, Al-Azzawe M, Aziz L et al (2014) Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres. Eur Arch Otorhinolaryngol 271:547–554CrossRefPubMed Karlsson TR, Al-Azzawe M, Aziz L et al (2014) Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres. Eur Arch Otorhinolaryngol 271:547–554CrossRefPubMed
9.
go back to reference Cohen EE, Karrison TG, Kocherginsky M, Mueller J, Egan R, Huang CH, Samant S (2014) Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer. J Clin Oncol 32(25):2735–2743CrossRefPubMedPubMedCentral Cohen EE, Karrison TG, Kocherginsky M, Mueller J, Egan R, Huang CH, Samant S (2014) Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer. J Clin Oncol 32(25):2735–2743CrossRefPubMedPubMedCentral
10.
go back to reference Haddad R, O’Neill A, Rabinowits G, Tishler R, Khuri F, Adkins D, Limaye S (2013) Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial. Lancet Oncol 14(3):257–264CrossRefPubMed Haddad R, O’Neill A, Rabinowits G, Tishler R, Khuri F, Adkins D, Limaye S (2013) Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial. Lancet Oncol 14(3):257–264CrossRefPubMed
11.
go back to reference Kitani Y, Kubota A, Furukawa M, Sato K (2016) Prognostic factors for local control in patients receiving radiation therapy for early glottic cancer: anterior commissure involvement and effect of chemoradiotherapy. Eur Arch Otorhinolaryngol 273:1011–1017CrossRefPubMed Kitani Y, Kubota A, Furukawa M, Sato K (2016) Prognostic factors for local control in patients receiving radiation therapy for early glottic cancer: anterior commissure involvement and effect of chemoradiotherapy. Eur Arch Otorhinolaryngol 273:1011–1017CrossRefPubMed
12.
go back to reference Lagha A, Chraiet N, Labidi S, Rifi H, Ayadi M, Krimi S, Kochbati L (2013) Larynx preservation: what is the best non-surgical strategy? Crit Rev Oncol Hematol 88(2):447–458CrossRefPubMed Lagha A, Chraiet N, Labidi S, Rifi H, Ayadi M, Krimi S, Kochbati L (2013) Larynx preservation: what is the best non-surgical strategy? Crit Rev Oncol Hematol 88(2):447–458CrossRefPubMed
13.
go back to reference Forastiere AA, Zhang Q, Weber RS, Maor MH, Goepfert H, Pajak TF, Thorstad W (2013) Long-term results of RTOG 91–11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 31(7):845–852CrossRefPubMed Forastiere AA, Zhang Q, Weber RS, Maor MH, Goepfert H, Pajak TF, Thorstad W (2013) Long-term results of RTOG 91–11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 31(7):845–852CrossRefPubMed
14.
go back to reference Karlsson TR, Al-Azzawe M, Aziz L, Hurman D, Finizia C (2014) Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres. Eur Arch Otorhinolaryngol 271(3):547–554CrossRefPubMed Karlsson TR, Al-Azzawe M, Aziz L, Hurman D, Finizia C (2014) Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres. Eur Arch Otorhinolaryngol 271(3):547–554CrossRefPubMed
15.
go back to reference Department of Veterans Affairs Laryngeal Cancer Study Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324(24):1685–1690CrossRef Department of Veterans Affairs Laryngeal Cancer Study Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324(24):1685–1690CrossRef
16.
go back to reference Wolf GT, Bellile E, Eisbruch A (2017) Survival rates using individualized bioselection treatment methods in patients with advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg 143:355–366CrossRefPubMedPubMedCentral Wolf GT, Bellile E, Eisbruch A (2017) Survival rates using individualized bioselection treatment methods in patients with advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg 143:355–366CrossRefPubMedPubMedCentral
17.
go back to reference Bonner J, Giralt J, Harari P (2016) Cetuximab and radiotherapy in laryngeal preservation for cancers of the larynx and Hypopharynx: a secondary analysis of a randomized clinical trial. JAMA Otolaryngol Head Neck Surg 142:842–849CrossRefPubMedPubMedCentral Bonner J, Giralt J, Harari P (2016) Cetuximab and radiotherapy in laryngeal preservation for cancers of the larynx and Hypopharynx: a secondary analysis of a randomized clinical trial. JAMA Otolaryngol Head Neck Surg 142:842–849CrossRefPubMedPubMedCentral
18.
go back to reference Leoncini E, Vukovic V, Cadoni G (2018) Tumour stage and gender predict recurrence and second primary malignancies in head and neck cancer: a multicentre study within the INHANCE consortium. Eur J Epidemiol 33:1205–1218CrossRefPubMedPubMedCentral Leoncini E, Vukovic V, Cadoni G (2018) Tumour stage and gender predict recurrence and second primary malignancies in head and neck cancer: a multicentre study within the INHANCE consortium. Eur J Epidemiol 33:1205–1218CrossRefPubMedPubMedCentral
19.
go back to reference Li ZQ, Zou L, Liu TR, Yang AK (2015) Prognostic value of body mass index before treatment for laryngeal squamous cell carcinoma. Cancer Biol Med 12:394–400PubMedPubMedCentral Li ZQ, Zou L, Liu TR, Yang AK (2015) Prognostic value of body mass index before treatment for laryngeal squamous cell carcinoma. Cancer Biol Med 12:394–400PubMedPubMedCentral
20.
go back to reference Daneshi N, Fararouei M, Mohammadianpanah M et al (2018) Effects of different treatment strategies and tumor stage on survival of patients with advanced laryngeal carcinoma: a 15-year cohort study. J Cancer Epidemiol 2018:9678097CrossRefPubMedPubMedCentral Daneshi N, Fararouei M, Mohammadianpanah M et al (2018) Effects of different treatment strategies and tumor stage on survival of patients with advanced laryngeal carcinoma: a 15-year cohort study. J Cancer Epidemiol 2018:9678097CrossRefPubMedPubMedCentral
22.
go back to reference Zhu X, Heng Y, Zhou L et al (2019) A prognostic nomogram for predicting risk of recurrence in laryngeal squamous cell carcinoma patients after tumor resection to assist decision making for postoperative adjuvant treatment. J Surg Oncol 120:698–706CrossRefPubMed Zhu X, Heng Y, Zhou L et al (2019) A prognostic nomogram for predicting risk of recurrence in laryngeal squamous cell carcinoma patients after tumor resection to assist decision making for postoperative adjuvant treatment. J Surg Oncol 120:698–706CrossRefPubMed
23.
go back to reference Chen F, Lin L, Liu F, Yan L, Qiu Y, Wang J, Wang R (2019) Three prognostic indexes as predictors of response to adjuvant chemoradiotherapy in patients with oral squamous cell carcinoma after radical surgery: a large-scale prospective study. Head Neck 41(2):301–308CrossRefPubMed Chen F, Lin L, Liu F, Yan L, Qiu Y, Wang J, Wang R (2019) Three prognostic indexes as predictors of response to adjuvant chemoradiotherapy in patients with oral squamous cell carcinoma after radical surgery: a large-scale prospective study. Head Neck 41(2):301–308CrossRefPubMed
24.
go back to reference Santoro L, Tagliabue M, Massaro MA, Ansarin M, Calabrese L, Giugliano G, Benazzo M (2015) Algorithm to predict postoperative complications in oropharyngeal and oral cavity carcinoma. Head Neck 37(4):548–556CrossRefPubMed Santoro L, Tagliabue M, Massaro MA, Ansarin M, Calabrese L, Giugliano G, Benazzo M (2015) Algorithm to predict postoperative complications in oropharyngeal and oral cavity carcinoma. Head Neck 37(4):548–556CrossRefPubMed
25.
go back to reference Hay A, Migliacci J, Zanoni DK, Patel S, Yu C, Kattan MW, Ganly I (2018) Validation of nomograms for overall survival, cancer-specific survival, and recurrence in carcinoma of the major salivary glands. Head Neck 40(5):1008–1015CrossRefPubMedPubMedCentral Hay A, Migliacci J, Zanoni DK, Patel S, Yu C, Kattan MW, Ganly I (2018) Validation of nomograms for overall survival, cancer-specific survival, and recurrence in carcinoma of the major salivary glands. Head Neck 40(5):1008–1015CrossRefPubMedPubMedCentral
26.
go back to reference Petersen JF, Stuiver MM, Timmermans AJ, Chen A, Zhang H, O’Neill JP, Skroder C (2018) Development and external validation of a risk-prediction model to predict 5-year overall survival in advanced larynx cancer. Laryngoscope 128(5):1140–1145CrossRefPubMed Petersen JF, Stuiver MM, Timmermans AJ, Chen A, Zhang H, O’Neill JP, Skroder C (2018) Development and external validation of a risk-prediction model to predict 5-year overall survival in advanced larynx cancer. Laryngoscope 128(5):1140–1145CrossRefPubMed
27.
go back to reference Sawant SS, Dongre H, Ahire C, Sharma S, Kannan S, Mahadik S, Vaidya MM (2017) A nomogram for predicting the risk of neck node metastasis in pathologically node-negative oral cavity carcinoma. Oral Dis 23(8):1087–1098CrossRefPubMed Sawant SS, Dongre H, Ahire C, Sharma S, Kannan S, Mahadik S, Vaidya MM (2017) A nomogram for predicting the risk of neck node metastasis in pathologically node-negative oral cavity carcinoma. Oral Dis 23(8):1087–1098CrossRefPubMed
28.
go back to reference Wang SJ, Patel SG, Shah JP, Goldstein DP, Irish JC, Carvalho AL, Gross ND (2013) An oral cavity carcinoma nomogram to predict benefit of adjuvant radiotherapy. JAMA Otolaryngol Head Neck Surg 139(6):554–559PubMed Wang SJ, Patel SG, Shah JP, Goldstein DP, Irish JC, Carvalho AL, Gross ND (2013) An oral cavity carcinoma nomogram to predict benefit of adjuvant radiotherapy. JAMA Otolaryngol Head Neck Surg 139(6):554–559PubMed
29.
go back to reference Sheu T, Fuller CD, Mendoza TR, Garden AS, Morrison WH, Beadle BM, Cleeland CS (2014) Nomogram for predicting symptom severity during radiation therapy for head and neck cancer. Otolaryngology Head Neck Surg 151(4):619–626CrossRef Sheu T, Fuller CD, Mendoza TR, Garden AS, Morrison WH, Beadle BM, Cleeland CS (2014) Nomogram for predicting symptom severity during radiation therapy for head and neck cancer. Otolaryngology Head Neck Surg 151(4):619–626CrossRef
Metadata
Title
Chemoradiotherapy vs radiotherapy for non-surgical locally advanced laryngeal squamous cell carcinoma patients: a propensity score-matched study and practical nomogram construction
Authors
Yuan Zhang
Zhipeng Wang
Yun Zheng
Publication date
29-12-2023
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 3/2024
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-023-08360-8

Other articles of this Issue 3/2024

European Archives of Oto-Rhino-Laryngology 3/2024 Go to the issue