Tumour Volume as a Predictor of Treatment Success in Patients with Laryngeal Cancer Treated with Primary Chemoradiotherapy

Objectives: To evaluate the prognostic significance of pretreatment tumour volume in predicting local control, with a functioning larynx, in patients with laryngeal cancer treated with primary chemoradiation. Methods: Thirty-two patients with American Joint Committee on Cancer stage II-IV squamous cell carcinoma of the larynx were retrospectively reviewed. All patients received concurrent chemoradiation between 2000 and 2007. Tumour volumes were contoured and calculated on computed tomography simulation scans. The median follow-up was 2.1 years. The median radiotherapy dose was 74.4 Gy. Results: Of the 32 patients, 20 had supraglottic tumours, 11 had glottic tumours, and 1 had a subglottic tumour. For the entire cohort of patients, the 5-year overall survival rate was 45% and the 5-year local control rate for patients with a functional larynx was 66%. In all, 80% of patients with supraglottic tumour volumes of ≤12 cm3 achieved local control with a functioning larynx compared with only 44% of patients with supraglottic tumour volumes of >12 cm3 (p = 0.0268). For glottic cancers, it was not possible to discern a relationship between tumour volume and tumour control. Conclusions: Pretreatment tumour volume of ≤12 cm3 predicted local control with a functioning larynx in patients with supraglottic squamous cell carcinoma treated with chemoradiation.