Changes in treatment of advanced laryngeal cancer 1985-2001
Presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, Los Angeles, CA, September 25-28, 2005.
Objective
In 1991, a randomized study was published and demonstrated that use of nonsurgical therapy (chemoradiation) provided similar survival to total laryngectomy (the gold standard) for patients with advanced-stage laryngeal cancer. The purpose of this study was to assess how treatment of advanced laryngeal cancer was influenced by such developments in non-surgical therapy.
Study design
Patterns of care study using National Cancer Database (1985-2001).
Results
The percentage of advanced-stage patients treated with chemoradiation increased from 8.3% to 20.8% while the proportion treated with radiation alone decreased from 38.9% to 23.0%. Use of chemoradiation increased at a significantly faster rate after the 1991 publication at both community cancer centers and teaching research facilities. The use of total laryngectomy decreased slightly during this period.
Conclusions
The use of chemoradiation increased after the 1991 publication. It was impossible to determine from the NCDB whether additional patients who could benefit from chemo-RT were not offered or did not complete this treatment option. We recommend that treatment recommendations discussed at tumor boards be recorded in cancer registries.
aDepartment of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia
bDepartment of Health Services Research, American Cancer Society, Atlanta, Georgia
cEmory University Rollins School of Public Health, Atlanta, Georgia
ABSTRACT