title: Combined chemoradiotherapy with local microwave hyperthermia for treatment of T3N0 laryngeal carcinoma: a retrospective study with long-term follow-up.
abstract: The purpose of our study was to test the efficacy and toxicity of hyperthermia in conjunction with chemoradiotherapy for T3N0 laryngeal cancer. From 1997-2006, 25 patients diagnosed with T3N0 laryngeal carcinoma who denied laryngectomy were selected for this retrospective study. Patients received a total dose of 70 Gy (2 Gy per fraction, 5 days per week) in combination with 6 weekly sessions of hyperthermia, in addition to weekly cisplatin chemotherapy. The hyperthermia device was operated as a 433 MHz microwave heating with water loaded and water-cooled waveguides. The temperature was monitored subcutaneously in the skin under the aperture of the waveguide. The median follow-up was 60 months, while 23 of 25 patients (92%) presented complete response to treatment. The two patients that did not respond to thermoradiotherapy underwent total laryngectomy, and during follow-up were alive and free of disease. According to EORTC/RTOG criteria, toxicity was mild: three patients (12%) presented grade III, eight (32%) presented grade II and 14 (56%) presented grade I acute skin toxicity. Grade III laryngeal late toxicity (vocal cord malfunction due to severe oedema) was noted in two patients (8%) at 6-8 months post-thermo-chemoradiotherapy. Tmin was correlated (Spearman rho, p < 0.05) with response to treatment as well as with acute skin toxicity and laryngeal function. When a patient with T3N0 laryngeal carcinoma denies laryngectomy, an alternative treatment is combined thermo-chemoradiotherapy which seems to be effective and generally tolerable with radiation-induced skin toxicity and/or late side effects. A larger patient cohort is needed to confirm these results.
authors.affiliation: Microwave and Optical Fibers Laboratory, Electrical and Computer Engineering, National Technical University of Athens, Greece;
authors.forename: V
authors.initials: V
authors.lastname: Kouloulias
authors.affiliation: 2nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, XAIDARI, Greece;
authors.forename: S
authors.initials: S
authors.lastname: Triantopoulou
authors.affiliation: Center of Radiation Oncology, Ygeia Hospital, Athens, Greece;
authors.forename: J
authors.initials: J
authors.lastname: Vrouvas
authors.affiliation: Medical Oncology Unit, Aretaieion University Hospital, Athens, Greece;
authors.forename: K
authors.initials: K
authors.lastname: Gennatas
authors.affiliation: Microwave and Optical Fibers Laboratory, Electrical and Computer Engineering, National Technical University of Athens, Greece;
authors.forename: N
authors.initials: N
authors.lastname: Ouzounoglou
authors.affiliation: 1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Athens, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Kouvaris
authors.affiliation: Center of Radiation Oncology, Ygeia Hospital, Athens, Greece;
authors.forename: P
authors.initials: P
authors.lastname: Karaiskos
authors.affiliation: Center of Radiation Oncology, Ygeia Hospital, Athens, Greece;
authors.forename: P
authors.initials: P
authors.lastname: Aggelakis
authors.affiliation: 1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Antypas
authors.affiliation: 1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Zygogianni
authors.affiliation: 1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Papavasiliou
authors.affiliation: 2nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, XAIDARI, Greece;
authors.forename: K
authors.initials: K
authors.lastname: Platoni
authors.affiliation: 2nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, XAIDARI, Greece;
authors.forename: N
authors.initials: N
authors.lastname: Kelekis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D055815:Young Adult
keywords: Follow-up; Hyperthermia; Laryngeal cancer; Radio-chemotherapy; Toxicity