Journal article
Predictors of chemotherapy and its effects in early stage squamous cell carcinoma of the larynx
Laryngoscope investigative otolaryngology, v 5(3), pp 445-452
Jun 2020
PMID: 32596486
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Squamous cell carcinoma (SCC) of larynx is a common head and neck cancer. For cases that are node negative, the role of definitive concurrent chemoradiation is unclear and not supported by guidelines but used at provider discretion. To address this knowledge gap, we examined the oncological outcomes with additional chemotherapy and factors correlated with the chemotherapy administration. Methods We queried the National Cancer Database for patients with early stage (T2N0M0) laryngeal SCC treated nonsurgically. Multivariable logistic regression identified predictors of chemotherapy. Multivariable Cox regression evaluated predictors of survival. Propensity matching accounted for indication biases. Results We identified 7181 patients meeting the eligibility criteria, of which 1568 (22%) patients received chemotherapy in addition to radiation. Predictors of chemotherapy use included younger age, Caucasian race, more remote year of treatment, higher grade, sites other than glottis, treatment at a community cancer center, and use of intensity-modulated radiation therapy. Median overall survival was not significantly different in the two arms analyzed-65 months (95% confidence interval [CI] 60, 72months) with chemotherapy compared to 70 months without chemotherapy (95% CI 66, 75 months, P<.37). Predictors for survival on propensity-matched multivariable analysis were increased age, male sex, less education, lower income, higher comorbidity score, receipt of treatment at a community center, and nonglottic sites. Conclusions This study shows no clear survival benefit with chemotherapy in early stage disease. Although this implies that chemotherapy should not be routinely delivered, individualized judgment and prospective studies are recommended as the biology behind this interesting finding is undefined. Level of Evidence 2C (Outcomes Research).
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Details
- Title
- Predictors of chemotherapy and its effects in early stage squamous cell carcinoma of the larynx
- Creators
- Thejus T. Jayakrishnan - Allegheny Health NetworkRichard J. White - Allegheny Health NetworkLarisa Greenberg - Allegheny Health NetworkAthanasios Colonias - Allegheny Health NetworkRodney E. Wegner - Allegheny Health Network
- Publication Details
- Laryngoscope investigative otolaryngology, v 5(3), pp 445-452
- Publisher
- Wiley
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000504113500001
- Scopus ID
- 2-s2.0-85092729865
- Other Identifier
- 991021930844404721
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InCites Highlights
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- Web of Science research areas
- Otorhinolaryngology