Clinical characteristics of subglottic cancer: emphasis on therapeutic management strategies for stage II subglottic cancer*

Abstract

Background: Subglottic cancer (SGC) is extremely rare, as most laryngeal cancers are localized to the glottic region. Accordingly, the clinical characteristics of SGC have not been well characterized.

Objectives: In the current study, SGCs were clinically evaluated, and the outcomes of radiotherapy (RT) in patients with stage II SGC were assessed.

Materials and Methods: Medical data derived from 11 patients with SGC, who were treated at our hospital between 1995 and 2019, were retrospectively reviewed.

Results: In our department SGC accounted for 3.9% of the 280 laryngeal cancer patients treated during the study period. At the time of SGC diagnosis, 9 (81.8%) had stage II cancer, 1 had stage III cancer, and 1 had stage IV cancer. Stage II SGC patients treated with concurrent chemoradiotherapy (CCRT) showed a significantly higher local control rate (p = .026) and laryngeal dysfunction free rate (p = .026) than those treated with RT alone. Salvage surgery, performed in 4 patients whose disease was not locally controlled with CCRT/RT, was successful in 3 patients.

Conclusion: As a treatment strategy for stage II SGC, CCRT is an acceptable initial treatment for laryngeal function and preservation while salvage surgery is effective for recurrence after CCRT/RT treatment.

Chinese abstract

背景：声门下癌（SGC）非常罕见, 因为大多数喉癌位置都局限于声门区。因此, SGC的临床特征尚未得到很好的描述。

目的：本研究对SGCs进行了临床评估, 并对II期SGC患者的放射治疗（RT）结果进行了评价。

材料与方法：回顾性分析1995年至2019年间在医院就诊的11例SGC患者的临床资料。

结果：在我们科, SGC占了3.9%在研究期间接受治疗的280名喉癌患者。在SGC诊断时, 9例(81.8%)有II期癌, 1例有III期癌, 1例有IV期癌。同期放化疗（CCRT）治疗II期SGC显示出比单独用RT治疗更较高的局部控制率（p＜¼.026）和无喉功能障碍率（p＜¼.026）。对4例病情未经CCRT/RT局部控制的患者行抢救性手术, 3例获得成功。

结论：作为II期SGC的一种治疗法, CCRT是一种可接受的喉功能保留的初始治疗法, 而抢救性手术是处理CCRT/RT治疗后复发的有效方法。

Keywords:

• Radiotherapy
• stage II
• subglottic cancer

Disclosure statement

The authors report no conflicts of interest.