The Treatment Strategy Choice For Locally Advanced Laryngeal Cancer:a Meta-analysis And Systematic Review

Purpose This meta-analysis compared the efficacy of laryngectomy and three larynx-preservation treatments in patients with advanced laryngeal cancer.Materials and methods The search strategy included PubMed、, Cochrane, EMBASE and CNKI、WanFang Database、VIP、CBM, were searched(until May 12, 2015).We also searched reference lists of articles as a complement.RCTs that evaluated laryngectomy plus radiation and four larynx-preserving strategies in patients with advanced laryngeal cancer. The outcomes assessed were the 5-year overall survival(OS), disease-free survival(DFS)、Larynx preservation rate(LP)、Pattern of Relapse and side effects.Results The search identified sixteen studies which were used for the meta-analysis(N = 2628 patients). OS was similar among the following treatments: RT→LG VS LG→RT VS LG and RT VS CT+RT VS CT→RT, Lymph node recurrence rate was higher in patients receiving LG than RT→LG. Locoregional recurrence rate was higher in patients receiving CT→RT than LG→RT. CT+RT was associated with the highest rate of Larynx preservation rate(LP) among RT VS CT+RT VS CT→RT.Conclusion These findings suggest that for the patients with advanced laryngeal cancer, laryngectomy plus radiation is better than laryngectomy only; LG→RT may be better than CT→RT; CT+RT was associated with the highest rate of Larynx preservation rate(LP) among RT VS CT+RT VS CT→RT.