Treatments for carcinoma of the subglottis

The following are treatment options for the stages of carcinoma of the subglottis. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Stages 1 and 2 carcinoma of the subglottis

Radiation therapy and surgery are the treatments used for stages 1 and 2 carcinoma of the subglottis.

Radiation therapy is a common treatment for stages 1 and 2 carcinoma of the subglottis.

Surgery is done if the tumour doesn’t respond to radiation therapy.

Stage 3 carcinoma of the subglottis

Treatment for stage 3 carcinoma of the subglottis is often a combination of surgery, radiation and chemotherapy.

Radiation therapy may be used:

with chemotherapy given during the same time period (chemoradiation)
alone after surgery or for people who cannot cope well with chemoradiation and surgery

Chemotherapy may be used:

with radiation therapy given during the same time period (chemoradiation)
as the first treatment (induction chemotherapy) before treatment with chemoradiation

Surgery done for stage 3 carcinoma of the subglottis includes a laryngectomy with a partial thyroidectomy and modified radical neck dissection. It is usually followed by radiation therapy.

Stage 4 carcinoma of the subglottis

Treatment for stage 4 carcinoma of the subglottis is often a combination of surgery and radiation.

Surgery done for stage 4 carcinoma of the subglottis includes a laryngectomy, total thyroidectomy and radical neck dissection. It is usually followed by radiation therapy.

Radiation therapy alone is used for people who can’t have or don’t want surgery.

Immunotherapy may be used to treat

metastatic

carcinoma of the subglottis. Pembrolizumab (Keytruda) may be used as a

first-line therapy

with or without chemotherapy. Nivolumab (Opdivo) may be used to treat metastatic carcinoma of the subglottis that has stopped responding to chemotherapy with platinum drugs such as cisplatin or carboplatin.

Recurrent carcinoma of the subglottis

Recurrent carcinoma of the subglottis means that the cancer has come back after it has been treated. Treatments for recurrences include:

further surgery with or without radiation therapy after surgery
further radiation therapy for small recurrences for people who cannot have or don’t want to have a laryngectomy
chemotherapy
immunotherapy

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Some clinical trials in Canada are open to people with laryngeal cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

American Cancer Society. Laryngeal and Hypopharyngeal Cancers. 2014. https://www.cancer.org/.
Ferris, RL, Blumenschein G, Fayette J, Guigay J, et al. Nivolumab for recurrent squamous cell carcinoma of the head and neck. New England Journal of Medicine. 2016.
Mendenhall WM, Werning JW. Cancer of the larynx: General principles and management. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 18a: 441-458.
Mendenhall WM, Werning JW, Pfister DG. Cancer of the head and neck. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 38: 422-473.
National Cancer Institute. Laryngeal Cancer Treatment for Health Professionals (PDQ®). 2016. http://www.cancer.gov/.

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