title: Treatment results and prognostic factors for advanced squamous cell carcinoma of the larynx treated with concurrent chemoradiotherapy.
abstract: OBJECTIVE
  To review our experience with concurrent chemoradiotherapy (CCRT) for patients with advanced resectable squamous cell carcinoma (SCC) of the larynx and to evaluate the factors affecting survival and larynx preservation.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  The records of 102 patients with stage III or IV resectable SCC of the larynx treated with CCRT between February 1994 and March 2009 were reviewed. Of 102 patients, 59 were treated with high-dose regimens, including cisplatin, 5-fluorouracil (5-FU), methotrexate, and leucovorin or docetaxel, cisplatin, and 5-FU, and 43 were treated with low-dose regimens, including carboplatin and uracil-tegafur or S-1. Radiotherapy was delivered 5 days a week using a single daily fraction of 1.8–2.0 Gray (Gy), to a total dose of 66.0–70.2 Gy. Overall survival (OS), disease-specific survival (DSS), and DSS with larynx preservation were estimated using Kaplan–Meier methods. The log-rank test and Cox proportional hazards regression were used to identify significant prognostic factors for DSS and DSS with larynx preservation.
  
  
  RESULTS
  The 5-year OS and DSS for all patients treated with CCRT were 63.9 and 70.7 %, respectively. The 5-year DSS with larynx preservation was 54.1 %. On multivariate analysis, N stage, synchronous multiple primary cancers, and the contents of chemotherapy were significant predictors of OS for patients undergoing CCRT; T stage, N stage, and the contents of chemotherapy were significant prognostic factors for larynx preservation.
  
  
  CONCLUSIONS
  The treatment method including the indication for CCRT may be determined by the contents of the chemotherapy and the T and N stages of laryngeal SCC. It is important to diagnose multiple synchronous primary cancers before CCRT.
authors: Takahide
authors: T
authors: Taguchi
authors: Goshi
authors: G
authors: Nishimura
authors: Masahiro
authors: M
authors: Takahashi
authors: Masanori
authors: M
authors: Komatsu
authors: Daisuke
authors: D
authors: Sano
authors: Naoko
authors: N
authors: Sakuma
authors: Yasuhiro
authors: Y
authors: Arai
authors: Yukiko
authors: Y
authors: Yamashita
authors: Osamu
authors: O
authors: Shiono
authors: Mariko
authors: M
authors: Hirama
authors: Yasunori
authors: Y
authors: Sakuma
authors: Jun-ichi
authors: J
authors: Ishitoya
authors: Masaharu
authors: M
authors: Hata
authors: Ichiro
authors: I
authors: Ogino
authors: Nobuhiko
authors: N
authors: Oridate
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome