Changes in treatment of advanced laryngeal cancer 1985-2001.
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.


METHODS
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.
Chen
Amy Y
AY
Department of Otolaryngology, Emory University School of Medicine, and Department of Health Services Research, American Cancer Society, Atlanta, Georgia 30329, USA. amy.chen@emoryhealthcare.org
Schrag
Nicole
N
Hao
Yongping
Y
Flanders
W Dana
WD
Kepner
James
J
Stewart
Andrew
A
Ward
Elizabeth
E
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D007825:Laryngectomy / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D008495:Medical Oncology / Q000639:trends*; D008875:Middle Aged; D014481:United States
D000970:Antineoplastic Agents