Non-surgical organ preservation strategies for locally advanced laryngeal tumors: what is the Italian attitude? Results of a national survey on behalf of AIRO and AIOM.
Chemoradiotherapy is the treatment mostly used as organ preservation (OP) strategy worldwide in advanced laryngo-hypopharyngeal cancer. Due to the not homogeneous results of the literature data regarding the pre-treatment assessment and treatment schedule in this setting of patients, the Italian societies of radiation oncology and medical oncology surveyed (by an online survey) their memberships regarding the Italian attitude on larynx preservation in clinical practice. The survey outline addressed different items such as: demographics (11 items), pre-treatment evaluation (12 items), treatment schedules (10 items) and outcomes (3 items). The survey was filled in by 116 clinical oncologists (64 % radiation and 36 % medical oncologists). Results highlighted that pretreatment evaluation was not homogeneous among the respondents. The treatment of choice for the OP program resulted the concurrent chemoradiotherapy (66 %). Induction chemotherapy was proposed mostly in case of aggressive tumors such as advanced stage (T4 or N3) and/or unfavorable primary sites (hypopharynx). Moreover, after induction chemotherapy, for responders patients most participants (46 %) proposed concurrent chemoradiotherapy, while 18 and 19 % proposed radiotherapy alone or radiotherapy and cetuximab, respectively. For patients with stable disease after induction chemotherapy, the respondents declared to suggest surgery, radiotherapy and cetuximab or radiotherapy alone in 38, 32 and 15 % of cases, respectively. Results of the present survey highlighted the variability of therapeutic approaches offered in clinical practice for patients candidate to a larynx OP program. Analysis of abovementioned results may give the chance to modify some clinical attitudes and create the background for future clinical investigation in this field.
Department of Radiotherapy, Advanced Radiotherapy Center, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy. daniela.alterio@ieo.it.
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Alterio
Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy.
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Franco
Medical Oncology Unit, Ospedale U. Parini, Aosta, Italy.
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Numico
Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
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Licitra
Genitourinary Unit, Division of Medical Oncology, European Institute of Oncology, Milan, Italy.
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Cossu Rocca
Department of Radiotherapy, Advanced Radiotherapy Center, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
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Ferrari
Medical Oncology, IRCCS-Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
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Pinto
Department of Radiation Oncology, Santa Croce General Hospital, Cuneo, Italy.
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Russi
Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy.
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Ricardi
Department of Radiotherapy, Advanced Radiotherapy Center, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.|University of Milan, Milan, Italy.
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Jereczek Fossa
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007558:Italy; D007822:Laryngeal Neoplasms / Q000628:therapy*; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D000077195:Squamous Cell Carcinoma of Head and Neck; D011795:Surveys and Questionnaires
Chemoradiotherapy; Laryngeal tumor; Organ preservation; Survey