Tumor volumes in T3 supraglottic cancers treated with radiotherapy in the modern era: A study of the Canadian Head & Neck Collaborative Research Initiative

Nauman H Malik; Rui Fu; Nicolin Hainc; Christopher W Noel; John R de Almeida; Ali Hosni; Shao Hui Huang; Eugene Yu; Agnieszka Dzioba; Andrew Leung; Arvindpaul Mangat; Danielle MacNeil; Anthony C Nichols; Shivaprakash B Hiremath; Santanu Chakraborty; Alborz Jooya; Marc Gaudet; Stephanie Johnson-Obaseki; Jonathan Whelan; Reza Forghani; Michael P Hier; Grégoire Morand; Khalil Sultanem; Joseph Dort; John Lysack; Wayne Matthews; Steven Nakoneshny; Gia Gill; Adam Globerman; Paul Kerr; Pejman Maralani; Irene Karam; Antoine Eskander

doi:10.1002/hed.27608

Tumor volumes in T3 supraglottic cancers treated with radiotherapy in the modern era: A study of the Canadian Head & Neck Collaborative Research Initiative

Head Neck. 2024 Mar;46(3):561-570. doi: 10.1002/hed.27608. Epub 2023 Dec 20.

Authors

Nauman H Malik^{1

2}, Rui Fu³, Nicolin Hainc^{4

5}, Christopher W Noel³, John R de Almeida⁶, Ali Hosni², Shao Hui Huang², Eugene Yu⁵, Agnieszka Dzioba⁷, Andrew Leung⁸, Arvindpaul Mangat⁸, Danielle MacNeil⁷, Anthony C Nichols⁷, Shivaprakash B Hiremath⁹, Santanu Chakraborty⁹, Alborz Jooya¹⁰, Marc Gaudet¹⁰, Stephanie Johnson-Obaseki¹¹, Jonathan Whelan¹¹, Reza Forghani^{12

13}, Michael P Hier¹², Grégoire Morand¹², Khalil Sultanem¹⁴, Joseph Dort¹⁵, John Lysack¹⁶, Wayne Matthews¹⁵, Steven Nakoneshny¹⁵, Gia Gill¹⁷, Adam Globerman¹⁸, Paul Kerr¹⁷, Pejman Maralani⁵, Irene Karam¹, Antoine Eskander³

Affiliations

¹ Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
² Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
³ Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
⁴ Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
⁵ Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
⁶ Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada.
⁸ Department of Radiology, Department of Medical Imaging, Western University, London, Ontario, Canada.
⁹ Department of Radiology, Division of Neuroradiology, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada.
¹⁰ Division of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
¹¹ Department of Otolaryngology-Head & Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
¹² Department of Otolaryngology Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, Québec, Canada.
¹³ Department of Radiology, University of Florida College of Medicine, Gainesville, Florida, USA.
¹⁴ Department of Oncology, McGill University, Jewish General Hospital, Montréal, Québec, Canada.
¹⁵ Division of Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada.
¹⁶ Section of Neuroradiology, Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁷ Department of Otolaryngology-Head & Neck Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
¹⁸ Department of Radiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

PMID: 38116716
DOI: 10.1002/hed.27608

Abstract

Purpose: To evaluate the association of primary tumor volume (TV) with overall survival (OS) and disease-free survival (DFS) in T3 N0-3M0 supraglottic cancers treated with intensity-modulated radiotherapy (IMRT).

Methods: This was a retrospective cohort study involving 239 patients diagnosed with T3 N0-3M0 supraglottic cancers between 2002 and 2018 from seven regional cancer centers in Canada. Clinical data were obtained from the patient records. Supraglottic TV was measured by neuroradiologists on diagnostic imaging. Kaplan-Meier method was used for survival probabilities, and a restricted cubic spline Cox proportional hazards regression analysis was used to analyze TV associations with OS and DFS.

Results: Mean (SD) of participants was 65.2 (9.4) years; 176 (73.6%) participants were male. 90 (38%) were N0, and 151 (64%) received concurrent systemic therapy. Mean TV (SD) was 11.37 (12.11) cm³ . With mean follow up (SD) of 3.28 (2.60) years, 2-year OS was 72.7% (95% CI 66.9%-78.9%) and DFS was 53.6% (47.4%-60.6%). Increasing TV was associated (per cm³ increase) with worse OS (HR, 1.01, 95% CI 1.00-1.02, p < 0.01) and DFS (HR, 1.01, 95% CI 1.00-1.02, p = 0.02).

Conclusions: Increasing primary tumor volume is associated with worse OS and DFS in T3 supraglottic cancers treated with IMRT, with no clear threshold. The findings suggest that patients with larger tumors and poor baseline laryngeal function may benefit from upfront laryngectomy with adjuvant radiotherapy.

Keywords: T3 supraglottic cancer; head and neck cancer; laryngeal cancer; radiotherapy; tumor volume.

MeSH terms

Canada
Carcinoma, Squamous Cell* / pathology
Disease-Free Survival
Female
Humans
Laryngeal Neoplasms* / pathology
Male
Neoplasm Staging
Retrospective Studies
Tumor Burden