title: Predisposing factors for larynx preservation strategies with non-surgical multimodality treatment for locally advanced (T3-4) larynx, hypopharynx and cervical esophageal disease.
abstract: OBJECTIVE
  To identify predisposing factors for larynx preservation strategies using non-surgical multimodality approaches.
  
  
  METHODS
  We retrospectively reviewed the records of 48 patients with T3-4 diseases (14 larynx, 19 hypopharynx, 15 cervical esophagus). Out of 48 patients, 33 refused surgery, and 15 were deemed inoperable, and a total of 25 were graded as T3 and 23 as T4. A total of 24 patients received induction chemotherapy. Radiotherapy was administered at a median dose of 61 Gy (range, 30-71 Gy). Concurrent chemotherapy was administered to all patients: intra-arterial infusion in 21, systemic infusion in 24, or both in 3.
  
  
  RESULTS
  Thirty-seven cases (77%) achieved a complete response. The 3-year local control, progression-free survival (PFS), overall survival (OS), and laryngeal preservation rates were 56%, 48%, 56%, and 73%, respectively. Tumor location, nodal involvement, and pre-treatment serum hemoglobin values were identified as predisposing factors for local control, PFS, and OS. Multivariate analysis revealed that the pre-treatment serum hemoglobin levels and tumor location were significant prognostic factors for PFS.
  
  
  CONCLUSIONS
  Tumor location and pre-treatment hemoglobin levels are important prognostic factors for PFS for non-surgical multimodal organ preservation treatment.
authors.affiliation: Department of Radiology, Kurume University, Fukuoka, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Suzuki
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan hideya10@hotmail.com.
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Department of Radiology, Kurume University, Fukuoka, Japan.
authors.forename: Etsuyo
authors.initials: E
authors.lastname: Ogo
authors.affiliation: Department of Radiology, Kurume University, Fukuoka, Japan.
authors.forename: Toshi
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Radiology, Kurume University, Fukuoka, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Eto
authors.affiliation: Department of Radiology, Kurume University, Fukuoka, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Muraki
authors.affiliation: Department of Radiology, Kurume University, Fukuoka, Japan.
authors.forename: Chikayuki
authors.initials: C
authors.lastname: Hattori
authors.affiliation: Department of Oto-rhino-laryngology, Kurume University, Fukuoka, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Umeno
authors.affiliation: Department of Radiology, Kurume University, Fukuoka, Japan.
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Kurume University, Fukuoka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Satoaki
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Larynx preservation; cervical esophageal cancer; chemoradiotherapy; hypopharyngeal cancer; laryngeal cancer