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Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancerDey P, Arnold D, Wight R, Kelly CG, McKenzie K
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SummaryNot enough evidence on which treatment is best for early stages of cancer in the vocal cords that has not spread to the voice box.Cancer of the larynx (voice box) usually begins in the glottis (vocal cords) as a squamous cell cancer (cancer in the membranes). Most people survive these cancers when they get treatment early (before the cancer spreads further into the larynx and surrounding area). Options include radiotherapy, open surgery (through the neck) or, more commonly now, endolaryngeal excision (surgery reaching the throat via the mouth, sometimes with a laser). The review of trials found there is not enough evidence to show which form of treatment might be better for people with early stage laryngeal squamous cell carcinoma. Such evidence may come from two new trials comparing radiotherapy and endolaryngeal excision, which have started.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
April 22. 2002 AbstractBackgroundRadiotherapy, open surgery and endolaryngeal excision (with or without laser) are all accepted modalities of treatment for early stage glottic cancer. Case series suggest that they confer similar survival advantage. Opinions on optimal therapy vary across disciplines and between countries. ObjectivesTo compare the effectiveness of open surgery, endolaryngeal excision (with or without laser) and radiotherapy in the management of early glottic laryngeal cancer. Search strategyWe searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, CENTRAL (The Cochrane Library, Issue 1, 2007), and the MEDLINE (from 1966 to April 2007), EMBASE (from 1980 to April 2007), CINAHL (from 1982 to April 2007) and CancerLit (from 1963 to April 2007) databases. Selection criteriaRandomised controlled trials comparing open surgery, endolaryngeal resection and/or radiotherapy. Data collection and analysisTwo authors independently assessed randomised controlled trials identified from the electronic searches for eligibility and methodological quality. All authors of the review discussed the results of these assessments. Main resultsOnly one randomised controlled trial was identified which compared open surgery and radiotherapy among a substantial number of patients with early glottic laryngeal cancer. Authors' conclusionsThere is currently insufficient evidence to guide management decisions on the most effective treatment. Interpretation of the only large scale randomised controlled trial comparing open surgery and radiotherapy in patients with early glottic cancer is limited because of concerns about the adequacy of treatment regimens and deficiencies in the reporting of the study design and analysis. Endolaryngeal resection of early glottic tumours is becoming more common. Two multicentre trials comparing endolaryngeal resection with radiotherapy are underway. |