Researchers from Massachusetts General Hospital have reported promising results of treatment of early-stage laryngeal cancer with a new laser called the pulsed angiolytic KTP. The details of this Phase II study were presented at the 2008 meeting of the Broncho-Esophagological Association meeting in Orlando, Florida, on May 1. Details of this study are available on the Massachusetts General Web site, and a definitive report will be published in the July 2008 issue of the Annals of Otology, Rhinology and Laryngology.^1 2

Laryngeal cancer can involve one of three areas of the larynx: supraglottis, glottis (vocal cords), and subglottis. Patients are usually treated with surgery and/or radiation therapy. Early glottic cancers can be treated with surgery or laser surgery. A recent study in the American Journal of Otolaryngology showed a 92% recurrence-free survival at two years for patients with Tis and T1 laryngeal cancers with a larynx preservation rate of 98%.³ A recent study also showed a 70% salvage rate for laser therapy in patients with laryngeal carcinoma who had failed surgery and/or radiation therapy.⁴

The current trial included 28 patients with early-stage laryngeal cancer (involving only the vocal cords); the outcomes of 22 were reported at the Broncho-Esophageal Association meeting. All patients received six weeks of treatment, carried out without anesthesia in an outpatient setting with each treatment taking 20 minutes. With a median follow-up of 27 months, there have been no recurrences. One of the apparent advantages of laser therapy over surgery or radiation therapy is preservation of the vocal cord function. These authors suggest that voice preservation is better with laser therapy than alternative treatments. However, at present treatment is limited to patients with small cancers on one or both vocal cords.

Comments: These results appear to substantiate other reports on the effectiveness of laser therapy for small laryngeal cancers. One of the most important outstanding issues will be to determine how large a lesion can be and still respond completely to laser therapy.

Related News:

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Concomitant Chemotherapy and Radiation Therapy Improve Larynx Preservation Rate in Potentially Resectable Stage III-IV Cancer of the Larynx (10/10/2002)

Reference:

¹ Zeitels SM et al. 2008 Meeting of the Bronco-Esophagological Society.

² Details available on the Massachusetts General Web site: http://www.massgeneral.org/news/inthenews/index.html#apr30. Also in the NY Times May 6 (Science Section).

³ Diode laser microsurgery for treatment of Tis and T1 glottic carcinomas. American Journal of Otolaryngology.

⁴ Grant DG, Salassa JR, Hinni ML et al. Transoral laser microsurgery for recurrent laryngeal and pharyngeal cancer. Otolaryngology Head and Neck Surgery. 2008;138:606-613.