Supraglottis
Glottis
Subglottis
Current Clinical Trials

Supraglottis

Standard treatment options:

1. External-beam radiation therapy alone for the smaller lesions.[1,2]
2. Supraglottic laryngectomy or total laryngectomy, depending on location of the lesion, clinical status of the patient, and expertise of the treatment team. Careful selection must be made to ensure adequate pulmonary and swallowing function postoperatively. Radiation should be preferred because of the good results, preservation of the voice, and the possibility of surgical salvage in patients whose disease recurs locally.[3]
3. Postoperative radiation therapy is indicated for positive or close surgical margins.

Treatment options under clinical evaluation:

1. Hyperfractionated radiation therapy to improve tumor control rates and diminish late toxicity to normal tissue.[2,4]
2. Isotretinoin (i.e., 13-cis-retinoic acid) daily for 1 year to prevent development of second upper aerodigestive tract primary tumors.[5]

Standard treatment options:

1. Radiation therapy.[1,2,6-8]
2. Partial or hemilaryngectomy or total laryngectomy, depending on anatomic considerations. Under certain circumstances, laser microsurgery may be appropriate.[9]

Treatment options under clinical evaluation:

1. Hyperfractionated radiation therapy to improve tumor control rates and diminish late toxicity to normal tissue.[2,4]
2. Isotretinoin daily for 1 year to prevent development of second upper aerodigestive tract primary tumors.[5]

Standard treatment options:

• Lesions can be treated successfully by radiation therapy alone with preservation of normal voice.[1,2] Surgery is reserved for failure of radiation therapy or for patients in whom follow-up is likely to be difficult.

Treatment options under clinical evaluation:

1. Hyperfractionated radiation therapy to improve tumor control rates and diminish late toxicity to normal tissue.[2,4]
2. Isotretinoin daily for 1 year to prevent development of second upper aerodigestive tract primary tumors.[5]

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II laryngeal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References

1. Mendenhall WM, Riggs CE Jr, Cassisi NJ: Treatment of head and neck cancers. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005, pp 662-732. 
   
   
2. Wang CC, ed.: Radiation Therapy for Head and Neck Neoplasms. 3rd ed. New York: Wiley-Liss, 1997. 
   
   
3. Ogura JH, Sessions DG, Spector GJ: Conservation surgery for epidermoid carcinoma of the supraglottic larynx. Laryngoscope 85 (11 pt 1): 1808-15, 1975.  [PUBMED Abstract]
   
   
4. Parsons JT, Mendenhall WM, Cassisi NJ, et al.: Hyperfractionation for head and neck cancer. Int J Radiat Oncol Biol Phys 14 (4): 649-58, 1988.  [PUBMED Abstract]
   
   
5. Hong WK, Lippman SM, Itri LM, et al.: Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med 323 (12): 795-801, 1990.  [PUBMED Abstract]
   
   
6. Mittal B, Marks JE, Ogura JH: Transglottic carcinoma. Cancer 53 (1): 151-61, 1984.  [PUBMED Abstract]
   
   
7. Medini E, Medini I, Lee CK, et al.: Curative radiotherapy for stage II-III squamous cell carcinoma of the glottic larynx. Am J Clin Oncol 21 (3): 302-5, 1998.  [PUBMED Abstract]
   
   
8. Mendenhall WM, Amdur RJ, Morris CG, et al.: T1-T2N0 squamous cell carcinoma of the glottic larynx treated with radiation therapy. J Clin Oncol 19 (20): 4029-36, 2001.  [PUBMED Abstract]
   
   
9. Steiner W: Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 14 (2): 116-21, 1993 Mar-Apr.  [PUBMED Abstract]
   
   

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