ENT Updates
Clinical Research

Treatment results, side effects and prognostic factors affecting survival in patients with larynx cancer

1.

Department of Radiation Oncology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey

2.

Department of Radiation Oncology, Antakya Government Hospital, Hatay, Turkey

3.

Department of Medical Oncology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey

4.

Department of Otolaryngology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey

ENT Updates 2013; 3: 69-76
DOI: 10.2399/jmu.2013002005
Read: 1095 Downloads: 757 Published: 03 February 2021

Objective: Our aim was to determine the treatment results, side effects and the prognostic factors affecting survival in patients with larynx cancer treated in our clinic.

Methods: Data of a total of 90 patients with larynx carcinoma were included in the study. The patients’ performance scores were evaluated according to the Eastern Cooperative Oncology Group (ECOG) system.

Results: Eighty-seven (97%) patients were male and three patients (3%) were female. The median age of the patients was 59 (37-86) years. Early-stage, locally advanced stage, and metastatic disease were detected in 43, 55, and 2% of the patients, respectively. Laryngeal cancers were observed in the glottic (53%), and supraglottic (47%) regions. Performance score (p=0.022), grade (p=0.033), lymph node metastasis (p=0.001), T stage (p=0.034) and disease stage (p=0.007) were significantly unfavourable in supraglottic cancers compared to glottic cancers. Recurrence was observed in 17% of the patients in a median 15 (range: 5-96) months. Distant metastasis was observed in 12% of the patients in a median 17 (range: 1-155) months. The factors affecting survival were the presence of comorbidities (p=0.032), performance status (p=0.022), hemoglobin level (p=0.003), T stage (p=0.006), disease stage (p=0.011), and weight loss (p=0.002). When RT- and CRT-associated side effects were compared, the incidence of adverse effects such as mucositis (p<0.001), nausea/vomiting (p<0.001), weight loss (p=0.005), neutropenia (p=0.001), and anemia (p=0.003) in patients under chemoradiotherapy was significantly higher than those associated with radiotherapy.

Conclusion: Hemoglobin level, T stage, presence of comorbidity and weight loss were independent prognostic factors.


Larinks kanserli hastaların tedavi sonuçları, yan etkileri ve sağkalımını etkileyen prognostik faktörler

Amaç: Bu çalışmada, kliniğimizde tedavi edilen larinks kanserli hastaların tedavi sonuçları, tedavilerin yan etkileri ve hastaların sağkalımını etkileyen prognostik faktörlerin belirlenmesi amaçlanmıştır.

Yöntem: Çalışmada 90 hasta verisi analiz edilmiştir. Hastaların performans statüsü 2010'da revize edilmiş Doğu Onkoloji İşbirliği Grubu (Eastern Cooperative Oncology Group, ECOG) skorlama sistemine göre değerlendirilmiştir.

Bulgular: Hastaların %97'si erkek ve %3'ü kadın olup, medyan yaşı 59 (37-86) idi. Erken evre %43, lokal ileri evre %55, metastatik evre kanser %2 hastada saptandı. Hastaların %53'ünü glottik kanserler, %47'sini supraglottik kanserler oluşturmaktaydı. Supraglottik kanserlerin performans durumu (p=0.022), grade (p=0.033), T evresi (p=0.034), lenf nod metastazı (p=0.001), hastalık evresi (p=0.007) bakımından glottik kanserlere göre daha kötü özelliklere sahip olduğu saptandı. Medyan 15 (dağılım: 5-96) ayda hastaların %17'sinde nüks, medyan 17 (dağılım: 1-155) ayda da hastaların %12'sinde uzak metastaz tespit edildi. Hastaların sağkalımını komorbidite (p=0.032), performans durumu (p=0.022), hemoglobin düzeyi (p=0.003), T evresi (p=0.006), hastalık evresi (p=0.011), kilo kaybı (p=0.002) etkilemekteydi. Kemoradyoterapi uygulanan hastalarda mukozit (p<0.001), bulantIı kusma (p<0.001), kilo kaybı (p=0.005), nötropeni (p=0.001) ve anemi (p=0.003), radyoterapi uygulanan hastalara göre daha fazla gözlenmiştiir.

Sonuç: Hemoglobin düzeyi, T evresi, komorbidite ve kilo kaybı bu hastalar için bağımsız prognostik faktörler olmuştur.

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