{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T09:17:08Z","timestamp":1769764628904,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the outcomes of advanced\u2010stage laryngeal squamous cell carcinoma (SCC) patients treated with functional\u2010preservation strategy with a specific focus on laryngo\u2010esophageal dysfunction disease\u2010free survival (LEDDFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>A retrospective review was conducted of stage III\u2010IVB laryngeal SCC patients who were treated with curative\u2010intent radiotherapy (RT) (2007\u20132018). Patients were preferentially managed with upfront chemoradiation (CCRT); except for those with cN2\u20103, cT4, or large volume cT3 (induction chemotherapy followed by RT or CCRT is an option), and those who were unfit or declined chemotherapy (received altered RT). The primary endpoint was 3\u2010year LEDDFS, and secondary endpoints were 3\u2010year local failure (LF), regional failure (RF), distant metastasis (DM), overall survival (OS), disease\u2010free survival (DFS), and acute and late toxicities. Cox proportional hazard tests were used for multivariable analysis (MVA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 213 cases were included. With a median follow\u2010up of 37\u2009months, the 3\u2010year LEDDFS was 50%, while the 3\u2010year OS, DFS, LF, RF, and DM were 81%, 74%, 9%, 5%, and 7%, respectively. On MVA, cT4\u2010category was the only predictor of inferior LEDDFS (HR: 0.47, [95% CI: 0.29\u20130.74], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). The most common grade \u2265\u20093 acute and late radiation therapy oncology group (RTOG) toxicity were esophageal toxicity: 16.7% and 29.6%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Primary RT resulted in favorable oncologic and functional outcomes in only half of the advanced\u2010stage laryngeal cancer patients. Future clinical trials are required to investigate further treatment options aiming to improve the oncologic and maintain functional outcomes with utilization of LEDDFS as the primary endpoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.972","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T13:15:43Z","timestamp":1669295743000},"page":"1866-1874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Primary radiation therapy for advanced\u2010stage laryngeal cancer: A laryngo\u2010esophageal dysfunction disease\u2010free survival"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0153-9131","authenticated-orcid":false,"given":"Issa","family":"Mohamad","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology King Hussein Cancer Center  Amman 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