Survival Rate of Patients with Squamous Cell Carcinoma of Larynx Undergoing Nonsurgical Treatments and Radiotherapy, From 2003 to 2015

Document Type: Original Article


1 Associate Professor, Department of Radiotherapy, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

2 Radiation Oncology Resident, Department of Radiotherapy, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

3 Postdoctoral Researcher, Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran


Background:The incidence rate of head and neck cancer in the world is about 560,000 new cases a year. Larynx cancer is the most common malignancy in head and neck in Iran. The most common head and neck carcinoma is the malignancy of squamous epithelial cells. This study was conducted to determine the survival rate of patients undergoing nonsurgical treatment methods for laryngeal squamous cell carcinoma in Kerman, Iran.
Methods:This retrospective study was conducted on patients with squamous cell carcinoma of larynx following nonsurgical treatment, who were referred to a radiation therapy center in Kerman, Iran, from 2003 to 2015.The likelihood of survival of patients based on the age, sex, stage of disease, non-surgical treatment, laryngeal preservation, as well as survival without progression and recurrence of the disease was determined.
Results:Mean age of the studied patients was 56.56 years. The patients had a mean survival rate of 52.92 months, mean disease free survival rate of 47.60 months and mean progression free survival rate of 11.29 months. The survival rate was higher in patients undergoing RT, followed by those undergoing CCRT and CT-RT (P<0.001). The patients had a one-year disease free survival rate of 69%, a three-year disease-free survival rate of 57% and a five-year disease-free survival rate of 44% and had a one-year progression free survival rate of 13% as well as a three- and a five-year progression free survival rate of 18%.
Conclusion: Overall survival rate was significantly different based on the type of non-surgical treatment, gender and the stage of cancer.


  1. Attar E, Dey S, Hablas A, Seifeldin IA, Ramadan M, Rozek LS, et al. Head and neck cancer in a developing country: a population-based perspective across 8 years. Oral Oncol. 2010;46(8):591–6.
  2. Stenson KM, Brockstein BE, Ross ME. Epidemiology and risk factors for head and neck cancer. UpToDate. 2014;
  3. Bhide SA, Nutting CM. Radiotherapy: future directions in head and neck cancer. Oncol News. 2007;1(4):7À9.
  4. Warnakulasuriya S. Living with oral cancer: epidemiology with particular reference to prevalence and life-style changes that influence survival. Oral Oncol. 2010;46(6):407–10.
  5. Mafi N, Kadivar M, Hosseini N, Ahmadi S, Zare-Mirzaie A. Head and neck squamous cell carcinoma in Iranian patients and risk factors in young adults: a fifteen-year study. Asian Pacific J Cancer Prev. 2012;13(7):3373–8.
  6. Llewelyn J, Mitchell R. Smoking, alochol and oral cancer in South East Scotland: A 10-year experience. Br J Oral Maxillofac Surg. 1994;32(3):146–52.
  7. McMillan AS, Pow EHN, Leung WK, Wong MCM, Kwong DLW. Oral health‐related quality of life in southern Chinese following radiotherapy for nasopharyngeal carcinoma. J Oral Rehabil. 2004;31(6):600–8.
  8. Henson BS, Inglehart MR, Eisbruch A, Ship JA. Preserved salivary output and xerostomia-related quality of life in head and neck cancer patients receiving parotid-sparing radiotherapy. Oral Oncol. 2001;37(1):84–93.
  9. Chen S-C, Lai Y-H, Liao C-T, Lin C-C, Chang JT-C. Changes of symptoms and depression in oral cavity cancer patients receiving radiation therapy. Oral Oncol. 2010;46(7):509–13.
  10. Mierzwa ML, Barrett WL, Gluckman JL. Radiation therapy for recurrent orbital hemangioma. Head Neck J Sci Spec Head Neck. 2003;25(5):412–5.
  11. Posner M. Evolving strategies for combined-modality therapy for locally advanced head and neck cancer. Oncologist. 2007;12(8):967–74.
  12. Shabani M, Larizadeh MH. A review of chemotherapy for locally advanced head and neck cancers. Reports Radiother Oncol. 2015;2(1).
  13. Ishiki H, Iwase S. Non-surgical treatment for locally advanced head and neck squamous cell carcinoma: beyond the upper limit. Transl Cancer Res. 2016;5(2):98–102.
  14. Jafari A, Gholizadeh N, Ramezani R, Razavi HE, Najafi S. Evaluation of survival rate in patients with laryngeal cancer. J Dent Med. 2017;30(2):89–96.
  15. Larizadeh MH, Damghani MA, Shabani M. Epidemiological characteristics of head and neck cancers in southeast of Iran. Iran J cancer Prev. 2014;7(2):80.
  16. Roychoudhury AK, Thukral S, Bansal N, Solanki S. Histopathological Characteristics of Head and Neck Neoplasms in a Tertiary Care Centre in South West Punjab. J Krishna Inst Med Sci. 2016;5(3).
  17. Arotiba GT, Ladeinde AL, Oyeneyin JO, Nwawolo CC, Banjo AAF. Malignant orofacial neoplasms in Lagos, Nigeria. East Afr Med J. 2006;83(3).
  18. Mehanna H, Paleri V, West CML, Nutting C. Head and neck cancer—part 1: epidemiology, presentation, and prevention. Bmj. 2010;341:c4684.
  19. Ramroth H, Schoeps A, Rudolph E, Dyckhoff G, Plinkert P, Lippert B, et al. Factors predicting survival after diagnosis of laryngeal cancer. Oral Oncol. 2011;47(12):1154–8.
  20. Al-Gilani M, Skillington SA, Kallogjeri D, Haughey B, Piccirillo JF. Surgical vs nonsurgical treatment modalities for T3 glottic squamous cell carcinoma. JAMA Otolaryngol Neck Surg. 2016;142(10):940–6.
  21. Roberts JC, Li G, Reitzel LR, Wei Q, Sturgis EM. No evidence of sex-related survival disparities among head and neck cancer patients receiving similar multidisciplinary care: a matched-pair analysis. Clin Cancer Res. 2010;16(20):5019–27.
  22. Daneshi N, Fararouei M, Mohammadianpanah M, Zare-Bandamiri M, Parvin S, Dianatinasab M. Effects of Different Treatment Strategies and Tumor Stage on Survival of Patients with Advanced Laryngeal Carcinoma: A 15-Year Cohort Study. J Cancer Epidemiol. 2018;2018.
  23. Dziegielewski PT, O’connell DA, Klein M, Fung C, Singh P, Mlynarek A, et al. Primary total laryngectomy versus organ preservation for T3/T4a laryngeal cancer: a population-based analysis of survival. J Otolaryngol Neck Surg. 2012;41.
  24. Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 2003;349(22):2091–8.
  25. Anschuetz L, Shelan M, Dematté M, Schubert AD, Giger R, Elicin O. Long-term functional outcome after laryngeal cancer treatment. Radiat Oncol. 2019;14(1):101.
  26. Bussu F, Miccichè F, Rigante M, Dinapoli N, Parrilla C, Bonomo P, et al. Oncologic outcomes in advanced laryngeal squamous cell carcinomas treated with different modalities in a single institution: a retrospective analysis of 65 cases. Head Neck. 2012;34(4):573–9.
  27. Bhattacharyya T, Kainickal CT. Current Status of Organ Preservation in Carcinoma Larynx. World J Oncol. 2018;9(2):39.
  28. Fu X, Zhou Q, Zhang X. Efficacy comparison between total laryngectomy and nonsurgical organ-preservation modalities in treatment of advanced stage laryngeal cancer: a meta-analysis. Medicine (Baltimore). 2016;95(14).
  29. Rosenthal DI, Mohamed ASR, Weber RS, Garden AS, Sevak PR, Kies MS, et al. Long‐term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: A 3‐decade survey. Cancer. 2015;121(10):1608–19.
  30. Chedid HM, Lehn CN, Rapoport A, Amar A, Franzi SA. Assessment of disease-free survival in patients with laryngeal squamous cell carcinoma treated with radiotherapy associated or not with chemotherapy. Braz J Otorhinolaryngol. 2010;76(2):225–30.
  31. Larizadeh MH, Damghani MA. Sequential chemoradiotherapy in advanced laryngeal cancer: an institutional experience. Asia‐Pacific J Clin Oncol. 2010;6(2):106–10.