UNASSIGNED: To perform a dosimetric comparison between intensity modulated radiotherapy (IMRT) and 3D conformal radiotherapy in patients with locally advanced (stage III and IV) tumours of the supraglottic region treated with conservative surgery and post-operative radiotherapy.
UNASSIGNED: An in-silico plan using a 3D conformal shrinking field technique was retrospectively produced for 20 patients and compared with actually delivered IMRT plans. Eighteen structures (arytenoids, constrictor muscles, base of tongue, floor of mouth, pharyngeal axis, oral cavity, submandibular glands and muscles of the swallowing functional units [SFU]) were considered.
UNASSIGNED: IMRT allowed a reduction of maximum and mean doses to 9 and 14 structures, respectively (p < .05).
UNASSIGNED: IMRT achieved a reduction of unnecessary dose to the remnant larynx and the majority of surrounding SFUs. Further prospective analyses and correlations with functional clinical outcomes are required to confirm these dosimetric findings.

Objective- To acknowledge patient-perceived voice-related and overall quality of life (QOL) in addition to disability index based on the validated voice-related quality of life survey (VRQOL), WHOQOL-BREF, and WHO DAS II questionnaires in T2 and early T3 laryngeal tumors after definitive radiotherapy. Methods- 35 patients of T2(15) and early T3(20) tumors were enrolled, assessed with three questionnaires of VRQOL, WHOQOL-BREF, and WHO DAS II before the start of radiotherapy, then at 12 and 24 weeks after radiotherapy, and the results were analyzed. Results- All 35 (100%) patients had significant vocal deterioration with a raw VRQOL score of more than 25 at the beginning, which significantly improved at 12 weeks post-radiotherapy (p < 0.5). However, VRQOL scores at the 12th and 24th weeks were statistically insignificant. On comparing the WHOQOL-BREF and WHO DAS II, domains of physical health, psychological health, and participation in society showed significant improvement in both the groups after radiotherapy except distress scores in T2 laryngeal cancers, where pre and post-radiotherapy scores were not significantly different suggesting residual distress. Conclusion- The QOL parameters improve significantly with treatment, however, there exists a persistence of residual distress even at 24 weeks after radiotherapy and hence, routine involvement of clinical psychologists should be emphasized in practice to alleviate anxiety, distress, and concerns regarding disease outcome and recurrence. 12 to 24 weeks post-radiotherapy can be an optimum time to gauge the improvement in the patient-related QOL outcome parameters and does not differ much between these durations.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-022-03397-3.

Background and objective The tumor\'s microenvironment is currently considered an important indicator of the tumor\'s prognosis, treatment failure, and recurrence. CD163+ tumor-associated macrophages (TAMs) are a marker of poor prognosis in many types of human cancers. In the present study, the expression of CD163+ TAMs was analyzed in laryngeal squamous cell carcinomas (LSCCs) using immunohistochemistry, and this expression was correlated with the clinical and pathological characteristics of LSCC patients. Materials and methods One commercial human larynx microarray with 80 cases of LSCCs, was used for this study. For comparison with normal laryngeal mucosa, a second microarray carrying normal tissues from all human anatomical sites, including normal laryngeal tissues, was used. Immunohistochemical staining was performed, and the primary antibody was a mouse monoclonal against human CD136. The absence of the primary antibody was used as a negative control. The percentage of positive cells was categorized into five scores: 0 (0%); 1, (1%-10%); 2, (11%-50%); 3, (51%-80%); and 4, (>80%). A case was scored as positive for CD163 with a score >= 1. The χ2 test was used to assess the CD163 expression in LSCC cases (N=80). A statistically significant difference was defined as P 0.05. Results The human larynx microarray containing 80 cases of LSCCs was used for this study. The age of the cancer patients in this array was in the range of 39 to 72, with a median of 53. LSCC grades were distributed as follows: 25 patients were designated as grade I, 43 were designated as grade II, and 6 were designated as grade III. Two tumors\' (2/80) cores were missing from the microarray. Six tumors on the microarray did not have a grade designation reported by the manufacturer of the array. The expression of CD163 in normal, benign, unmatched laryngeal tissue was absent. In cancer cases, on the other hand, a significant number of LSCCs had TAMs that were positive for CD163 (87% positive tumors, with an IHC score ranging from 1 to 4, χ2=30.634; p<0.001). The rest of the LSCC cases (10 in total) had negative CD163 expression (score of 0). Conclusion A significant majority of LSCCs were found to have CD163+ TAMs expression using tissue microarrays (TMAs). This expression is positively correlated with the tumor\'s grade, clinical manifestation, and TNM staging. Morphologic evidence shows that the majority of LSCCs express the highest range of immunohistochemistry (IHC) scores for CD163 protein in the membranes and cytoplasm of their TAMs. This study provides evidence of the clinical significance of CD163+TAMs in LSCCs and proposes further studies to pinpoint the exact role of these cells in LSCC patients.

OBJECTIVE: To investigate the effect of cisplatin injections combined with low-temperature plasma radiofrequency ablation on the clinical efficacy and serum survivin levels in advanced laryngeal cancer patients.
METHODS: A total of 42 patients with locally advanced laryngeal cancer treated in our hospital from January 2018 to June 2020 were recruited as the study cohort and placed in a control group (21 cases) or a treatment group (21 cases) according to the medication administered to each patient. The patients in the control group were treated with CO2 laser resections under laryngoscopy combined with cisplatin injections, and the patients in the observation group were treated with low-temperature plasma radiofrequency ablation combined with cisplatin injections. The clinical efficacies in the two groups were observed and the WHOQOL-BREF scores, tumor marker levels, and serum survivin levels were compared.
RESULTS: After the treatment, the ORR and CBR in the control group were 33.3% and 61.9%, respectively, levels that were significantly lower than the 66.7% and 90.5% in the observation group (P<0.05). The observation group\'s physiological, psychological, and social relations dimension scores were significantly higher than the corresponding scores in the control group (P<0.05). The tumor markers in the observation group were significantly lower in the serum CA72-4, CA19-9, and SCC-Ag levels than they were in the control group (P<0.05). The observation group exhibited lower serum survivin levels than the control group (P<0.05). Conclusion Cisplatin injections combined with low-temperature plasma radiofrequency ablation has a significant effect on the treatment of locally advanced laryngeal cancer. It can improve patients\' quality of life, reduce the tumor marker levels in the body, and inhibit the serum survivin levels.

UNASSIGNED: Tobacco and alcohol are the main etiological factors common to laryngeal cancers. However, the Human Papilloma Virus (HPV) constitutes an alternative risk factor according to several studies. In Tunisia, despite the annual increasing incidence of laryngeal squamous cell carcinoma (LSCC), the prevalence and prognostic significance of HPV have never been explored.In this study, we sought to highlight HPV DNA in 70 biopsies of laryngeal cancer, and to analyze the status of HPV infection in association with p53, p16, survivin, and IGF-1R expressions.
UNASSIGNED: HPV high risk (HPV HR) DNA was detected in tumors by in situ hybridization. However, the expression of p53, p16, survivin and IGF-1R were stained by immunohistochemistry test. The correlations of HPV status with clinicopathological parameters, overall survival, disease-free survival and proteins expressions were statistically evaluated.
UNASSIGNED: HPV HR DNA was detected in 39 out of 70 (55.71%) laryngeal tumors. HPV+ patients have a better overall survival (P = .081) and long disease-free-survival (P = .016) with a low rate of recurrence (P = .006) than HPV- patients. No significant correlations were found between HPV HR status and clinicopathological parameters (all P > .005). Moreover, HPV+ tumors were not associated with expression of p53, p16 and survivin. However, HPV HR status correlates with weak to moderate IGF-1R expression (P = .043).
UNASSIGNED: The substantial detection of HPV HR in LSCC tumors suggest that this virus plays an important part in laryngeal cancer in Tunisia. It is a good prognostic factor. In addition, HPV infection could act to block the pathway of IGF-1R expression.

Objective Emerging data have demonstrated suboptimal outcomes among patients with stage II larynx cancer. Our objective is to report survival outcomes for T2N0M0 larynx cancer and to determine the cause-specific survival. Study Design Case series with planned data collection. Setting Tertiary academic center. Subjects Adults with T2N0M0 squamous cell carcinoma of the larynx treated with curative intent. Methods A head and neck cancer epidemiology database was queried for eligible subjects from 2003 to 2014. Data were extracted from the electronic medical record and research database, and survival analyses were performed. Results Thirty-four patients with previously untreated stage II larynx cancer were identified (median follow-up 48 months). Patients included 27 males and 7 females with a mean age of 59 years. The majority of tumors arose from the glottis (59%). Of the cohort, 12% were treated with surgery, 65% radiation therapy, and 24% chemoradiation therapy. The estimated 2-year overall survival was 81%, (95% confidence interval [CI], 59%-92%), disease-specific survival was 91% (95% CI, 69%-98%), and recurrence-free survival was 84% (95% CI, 65%-93%). Four of 5 patients with persistent or recurrent disease posttreatment were successfully salvaged with total laryngectomy with 100% locoregional control. There were 11 mortalities (2 disease related, 2 due to metachronous primaries, 3 treatment related, and 4 from other/unknown causes). Conclusion Stage II laryngeal cancer has suboptimal survival outcomes. This appears to be a reflection of medical comorbidities, propensity for metachronous primaries, and the sequelae of late treatment effects rather than poor locoregional control.

OBJECTIVE: Adenoid cystic carcinoma is a malignant minor salivary gland tumor that represents <1% of all laryngeal tumors. The submucosal location of laryngeal adenoid cystic carcinoma (LACC) results in delayed presentation. Here, we present the first systematic review of reported cases of LACC to determine trends in presentation, diagnostic and treatment modalities, and patient outcome.
METHODS: PubMed, Web of Science, MEDLINE, and EMBASE databases.
METHODS: A search of the above databases was done to identify articles reporting cases of LACC. The variables included in the analysis were patient demographics, presenting symptoms, tumor location, imaging, treatment, follow-up time, recurrence, and outcome.
RESULTS: A total of 50 articles and 120 cases were included in the review. The most common presenting symptom was dyspnea (48.8%), followed by hoarseness (43.9%). LACC arose most frequently from the subglottis (56.7%). At presentation, 14.6% (13 of 89) of patients had regional disease. The average follow-up time was 54.0 months. At follow-up, distant metastasis was reported in 30 cases (33.3%). Surgery alone (43.3%) and surgery with radiotherapy (43.3%) were used most frequently and resulted in 57.1% and 55.3% of patients alive with no evidence disease at follow-up, respectively.
CONCLUSIONS: LACC was most often located in the subglottis. Patients commonly presented with dyspnea and hoarseness. In this systematic review, surgery with radiotherapy and surgery alone were the most commonly employed treatment modalities, and both resulted in slightly more than 50% of patients alive with no evidence of disease at follow-up.

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OBJECTIVE: Laryngeal chondrosarcoma (LC) is a rare entity, reportedly comprising less than 1% of all laryngeal tumors. Consequently, the incidence and survival of patients with this slow-growing tumor has been difficult to study. Our objective was to evaluate incidence, organized by patient demographics, as well as long-term survival trends of this malignancy using a population-based database.
METHODS: Retrospective analysis of the United States National Cancer Institute\'s Surveillance, Epidemiology, and End Results (SEER) registry.
METHODS: The SEER database was searched for patients diagnosed with LC between 1973 and 2010. Data analyzed included patient demographics, incidence, treatment modality, and survival.
RESULTS: One-hundred and forty-three cases were identified, representing 0.2% of all laryngeal tumors. Median age at diagnosis was 61.7 years. Men and women constituted 76.2% and 23.8% of patients, respectively. Tumors were locally invasive with 37.7% T4 disease and infrequent regional and distant metastases. The 1-year, 5-year, and 10-year disease-specific survival for LC was 96.5%, 88.6%, and 84.8%, respectively, compared to 88.3%, 68.2%, and 59.3%, respectively for patients with all other laryngeal tumors (P values < 0.01). Relative survival was 94.9% at 1 year, 88.5% at 5 years, and 88.4% at 10 years.
CONCLUSIONS: This analysis represents the largest LC study sample to date, allowing for evaluation of incidence and long-term survival. LC occurs infrequently, is locally invasive, but only rarely metastasizes. Prognosis for LC is significantly better than for other laryngeal malignancies.

OBJECTIVE: The study was undertaken to identify the common type of lesions, and the age, sex distribution, symptomatology, sites of involvement and prognosis of the same.
METHODS: A two-year prospective study was conducted from January 2005 to December 2006.
METHODS: The study was conducted at SMS Medical College, Jaipur, Rajasthan, India-a tertiary referral hospital.
METHODS: A total of 50 patients with benign laryngeal lesions were included in the study based on symptoms such as hoarseness of voice, foreign body sensation, throat pain, neck mass and cough and with positive clinical findings on indirect laryngoscopy and neck examination. The patients were in the age group of 14-63 years. All nonoperative cases and malignant cases were excluded. Diagnostic hematological and radiological investigations and therapeutic microlarygoscopic procedures were employed.
RESULTS: A male preponderance with a male:female ratio of 2.5:1 was observed. Majority of the patients were in the age group of 21-30 years. Vocal cord polyps were observed to be the commonest type of lesions. In our study, hoarseness of voice, cough, foreign body sensation and throat pain were found to be the commonest symptoms. Out of the 50 patients in the study group, only 6% patients got complete relief with voice rest and vocal rehabilitation; 94% patients required surgery, which included microlarygoscopy and endolaryngeal surgery. There was no recurrence in cases of vocal polyps and nodules during the period of observation.
CONCLUSIONS: Microlaryngeal surgery and voice rest offer a cost-effective, useful and safe method for the management of benign laryngeal lesions. With the inclusion of lasers, they can be more precisely operated. As such, the standard treatment of choice in all types of benign tumors of the larynx should consist of a triad of approach by microlaryngeal surgery (either microscopic or endoscopic, with or without use of lasers), voice rest and vocal rehabilitation.