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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="PDQ Cancer Information Summaries [Internet]" /><meta name="citation_title" content="Childhood Laryngeal Tumors Treatment (PDQ®)" /><meta name="citation_publisher" content="National Cancer Institute (US)" /><meta name="citation_date" content="2018/01/09" /><meta name="citation_author" content="PDQ Pediatric Treatment Editorial Board" /><meta name="citation_pmid" content="29337477" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK475829/" /><meta name="citation_keywords" content="laryngeal cancer" /><meta name="citation_keywords" content="childhood laryngeal cancer" /><meta name="citation_keywords" content="laryngeal papillomatosis" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Childhood Laryngeal Tumors Treatment (PDQ®)" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Cancer Institute (US)" /><meta name="DC.Contributor" content="PDQ Pediatric Treatment Editorial Board" /><meta name="DC.Date" content="2018/01/09" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK475829/" /><meta name="description" content="Treatment for children with laryngeal tumors depends upon the type; most are rhabdomyosarcoma and treated with chemotherapy and radiation therapy. Squamous cell carcinoma is managed with surgery and radiation therapy. Get detailed treatment information in this summary for clinicians." /><meta name="og:title" content="Childhood Laryngeal Tumors Treatment (PDQ®)" /><meta name="og:type" content="book" /><meta name="og:description" content="Treatment for children with laryngeal tumors depends upon the type; most are rhabdomyosarcoma and treated with chemotherapy and radiation therapy. Squamous cell carcinoma is managed with surgery and radiation therapy. Get detailed treatment information in this summary for clinicians." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK475829/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/pdqcis/CDR0000790385/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK475829/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK475829_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK475829_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK475829_"><span class="title" itemprop="name">Childhood Laryngeal Tumors Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Health Professional Version</div><p class="contrib-group"><span itemprop="author">PDQ Pediatric Treatment Editorial Board</span>.</p><p class="small">Published online: December 8, 2022.</p><p class="small">Created: <span itemprop="datePublished">January 9, 2018</span>.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000790385__1556">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of childhood laryngeal cancer and papillomatosis. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions.</p><p id="CDR0000790385__1557">This summary is reviewed regularly and updated as necessary by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p></div><div id="CDR0000790385__1840"><h2 id="_CDR0000790385__1840_">Childhood Laryngeal Cancer</h2><div id="CDR0000790385__1841"><h3>Histology</h3><p id="CDR0000790385__1842">Tumors of the larynx are rare. The most common benign tumor is subglottic hemangioma.[<a class="bk_pop" href="#CDR0000790385_rl_1840_1">1</a>] Malignant
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tumors, which are especially rare, may be associated with benign tumors such as polyps and
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papillomas.[<a class="bk_pop" href="#CDR0000790385_rl_1840_2">2</a>,<a class="bk_pop" href="#CDR0000790385_rl_1840_3">3</a>] A review of Surveillance, Epidemiology, and End Results (SEER) Program data from 1973 to 2016 identified 23 pediatric patients with laryngeal malignancies. Sixteen of the patients had squamous cell carcinoma; the other identified histologies included small cell carcinoma, mucoepidermoid carcinoma, myxosarcoma, embryonal rhabdomyosarcoma, and synovial sarcoma.[<a class="bk_pop" href="#CDR0000790385_rl_1840_4">4</a>]</p></div><div id="CDR0000790385__1843"><h3>Clinical Presentation</h3><p id="CDR0000790385__1844">These tumors may present with the following:</p><ul id="CDR0000790385__1883"><li class="half_rhythm"><div>Hoarseness.</div></li><li class="half_rhythm"><div>Difficulty swallowing.</div></li><li class="half_rhythm"><div>Enlargement of the lymph nodes of the neck.</div></li></ul></div><div id="CDR0000790385__1477"><h3>Treatment of Childhood Laryngeal Cancer</h3><p id="CDR0000790385__1884"> Squamous cell carcinoma of the larynx in children is managed in the same manner as it is in adults with
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carcinoma at this site, using surgery and radiation therapy.[<a class="bk_pop" href="#CDR0000790385_rl_1840_4">4</a>,<a class="bk_pop" href="#CDR0000790385_rl_1840_5">5</a>] Pediatric patients with squamous cell carcinoma of the larynx have outcomes that are similar to those reported for adult patients.[<a class="bk_pop" href="#CDR0000790385_rl_1840_4">4</a>] Laser surgery may be the
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initial treatment used for these lesions. For more information about the treatment of laryngeal cancer in adults, see <a href="/books/n/pdqcis/CDR0000062922/">Laryngeal Cancer Treatment (Adult)</a>.</p></div><div id="CDR0000790385__1811"><h3>Treatment Options Under Clinical Evaluation for Childhood Laryngeal Cancer</h3><p id="CDR0000790385__1873">Information about National Cancer Institute (NCI)–supported clinical trials can be found on the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>. For information about clinical trials sponsored by other organizations, see the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov website</a>.</p><p id="CDR0000790385__1812">The following is an example of a national and/or institutional clinical trial that is currently being conducted:</p><ul id="CDR0000790385__1813"><li class="half_rhythm"><div class="half_rhythm"><b><a href="https://www.cancer.gov/clinicaltrials/NCT03155620" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">APEC1621 (NCT03155620)</a></b> (Pediatric MATCH: Targeted Therapy Directed by Genetic Testing in Treating Pediatric Patients with Relapsed or Refractory Advanced Solid Tumors, Non-Hodgkin Lymphomas, or Histiocytic Disorders)<b>:</b> NCI-COG Pediatric Molecular Analysis for Therapeutic Choice (MATCH), referred to as Pediatric MATCH, will match targeted agents with specific molecular changes identified in a patient's tumor (refractory or recurrent). Children and adolescents aged 1 to 21 years are eligible for the trial.</div><div class="half_rhythm">Patients with tumors that have molecular variants addressed by open treatment arms in the trial may be enrolled in treatment on Pediatric MATCH. Additional information can be obtained on the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/pediatric-match" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a> and <a href="https://clinicaltrials.gov/ct2/show/NCT03155620" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov website</a>.
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</div></li></ul></div><div id="CDR0000790385_rl_1840"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000790385_rl_1840_1">Bitar MA, Moukarbel RV, Zalzal GH: Management of congenital subglottic hemangioma: trends and success over the past 17 years. Otolaryngol Head Neck Surg 132 (2): 226-31, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/15692531" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15692531</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1840_2">McGuirt WF, Little JP: Laryngeal cancer in children and adolescents. Otolaryngol Clin North Am 30 (2): 207-14, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9052665" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9052665</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1840_3">Bauman NM, Smith RJ: Recurrent respiratory papillomatosis. Pediatr Clin North Am 43 (6): 1385-401, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8973518" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8973518</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1840_4">Forsyth AM, Camilon PR, Tracy L, et al.: Pediatric laryngeal tumors and demographics, management, and survival in laryngeal squamous cell carcinoma. Int J Pediatr Otorhinolaryngol 140: 110507, 2021. [<a href="https://pubmed.ncbi.nlm.nih.gov/33279850" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33279850</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1840_5">Siddiqui F, Sarin R, Agarwal JP, et al.: Squamous carcinoma of the larynx and hypopharynx in children: a distinct clinical entity? Med Pediatr Oncol 40 (5): 322-4, 2003. [<a href="https://pubmed.ncbi.nlm.nih.gov/12652621" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12652621</span></a>]</div></li></ol></div></div><div id="CDR0000790385__1864"><h2 id="_CDR0000790385__1864_">Special Considerations for the Treatment of Children With Cancer</h2><p id="CDR0000790385__1865">Cancer in children and adolescents is rare, although the overall incidence has been slowly increasing since 1975.[<a class="bk_pop" href="#CDR0000790385_rl_1864_1">1</a>] Referral to medical centers with multidisciplinary teams of cancer specialists experienced in treating cancers that occur in childhood and adolescence should be considered. This multidisciplinary team approach incorporates the skills
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of the following health care professionals and others to ensure that children receive treatment, supportive care, and rehabilitation
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that will achieve optimal survival and quality of life:</p><ul id="CDR0000790385__1866"><li class="half_rhythm"><div>Primary care physicians.</div></li><li class="half_rhythm"><div>Pediatric surgeons.</div></li><li class="half_rhythm"><div>Radiation
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oncologists.</div></li><li class="half_rhythm"><div>Pediatric medical oncologists/hematologists.</div></li><li class="half_rhythm"><div> Rehabilitation
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specialists.</div></li><li class="half_rhythm"><div>Pediatric nurse specialists.</div></li><li class="half_rhythm"><div>Social workers.</div></li><li class="half_rhythm"><div>Child-life professionals.</div></li><li class="half_rhythm"><div>Psychologists.</div></li></ul><p id="CDR0000790385__1867">For specific information about supportive care for children and adolescents with cancer, see the summaries on <a href="https://www.cancer.gov/publications/pdq/information-summaries/supportive-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Supportive and Palliative Care</a>.</p><p id="CDR0000790385__1868">The American Academy of Pediatrics has outlined guidelines for
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pediatric cancer centers and their role in the treatment of pediatric patients
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with cancer.[<a class="bk_pop" href="#CDR0000790385_rl_1864_2">2</a>] At
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these pediatric cancer centers, clinical trials are available for most types of cancer that occur in children and adolescents, and the opportunity
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to participate is offered to most patients and their families. Clinical
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trials for children and adolescents diagnosed with cancer are generally
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designed to compare potentially better therapy with current standard therapy. Most of the progress made in identifying curative
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therapy for childhood cancers has been achieved through clinical trials.
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Information about ongoing clinical trials is available from the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><p id="CDR0000790385__1869">Dramatic improvements in survival have been achieved for children and adolescents with cancer. Between 1975 and 2020, childhood cancer mortality decreased by more than 50%.[<a class="bk_pop" href="#CDR0000790385_rl_1864_3">3</a>-<a class="bk_pop" href="#CDR0000790385_rl_1864_5">5</a>] Childhood and adolescent cancer survivors require close monitoring because side effects of cancer therapy may persist or develop months or years after treatment. For information about the incidence, type, and monitoring of late effects in childhood and adolescent cancer survivors, see <a href="/books/n/pdqcis/CDR0000343584/">Late Effects of Treatment for Childhood Cancer</a>.</p><p id="CDR0000790385__1870">Childhood cancer is a rare disease, with about 15,000 cases diagnosed annually in the United States in individuals younger than 20 years.[<a class="bk_pop" href="#CDR0000790385_rl_1864_6">6</a>] The U.S. <a href="https://www.congress.gov/107/plaws/publ280/PLAW-107publ280.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Rare Diseases Act of 2002</a> defines a rare disease as one that affects populations smaller than 200,000 people. Therefore, all pediatric cancers are considered rare.</p><p id="CDR0000790385__1888">The designation of a rare tumor is not uniform among pediatric and adult groups. In adults, rare cancers are defined as those with an annual incidence of fewer than six cases per 100,000 people. They account for up to 24% of all cancers diagnosed in the European Union and about 20% of all cancers diagnosed in the United States.[<a class="bk_pop" href="#CDR0000790385_rl_1864_7">7</a>,<a class="bk_pop" href="#CDR0000790385_rl_1864_8">8</a>] Also, the designation of a pediatric rare tumor is not uniform among international groups, as follows:</p><ul id="CDR0000790385__1871"><li class="half_rhythm"><div class="half_rhythm">A consensus effort between the European Union Joint Action on Rare Cancers and the European Cooperative Study Group for Rare Pediatric Cancers estimated that 11% of all cancers in patients younger than 20 years could be categorized as very rare. This consensus group defined very rare cancers as those with annual incidences of fewer than 2 cases per 1 million people. However, three additional histologies (thyroid carcinoma, melanoma, and testicular cancer) with incidences of more than 2 cases per 1 million people were also included in the very rare group because there is a lack of knowledge and expertise in the management of these tumors.[<a class="bk_pop" href="#CDR0000790385_rl_1864_9">9</a>]</div></li><li class="half_rhythm"><div class="half_rhythm">The Children's Oncology Group (COG) defines rare pediatric cancers as those listed in the International Classification of Childhood Cancer subgroup XI, which includes thyroid cancers, melanomas and nonmelanoma skin cancers, and multiple types of carcinomas (e.g., adrenocortical carcinomas, nasopharyngeal carcinomas, and most adult-type carcinomas such as breast cancers, colorectal cancers, etc.).[<a class="bk_pop" href="#CDR0000790385_rl_1864_10">10</a>] These diagnoses account for about 5% of the cancers diagnosed in children aged 0 to 14 years and about 27% of the cancers diagnosed in adolescents aged 15 to 19 years.[<a class="bk_pop" href="#CDR0000790385_rl_1864_4">4</a>]</div><div class="half_rhythm"> Most cancers in subgroup XI are either melanomas or thyroid cancers, with other cancer types accounting for only 2% of the cancers in children aged 0 to 14 years and 9.3% of the cancers in adolescents aged 15 to 19 years.</div></li></ul><p id="CDR0000790385__1872">These rare cancers are extremely challenging to study because of the low number of patients with any individual diagnosis, the predominance of rare cancers in the adolescent population, and the lack of clinical trials for adolescents with rare cancers.</p><p id="CDR0000790385__1837">Information about these tumors may also be found in sources relevant to
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adults with cancer, such as <a href="/books/n/pdqcis/CDR0000062922/">Laryngeal Cancer Treatment (Adult)</a>.</p><div id="CDR0000790385_rl_1864"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000790385_rl_1864_1">Smith MA, Seibel NL, Altekruse SF, et al.: Outcomes for children and adolescents with cancer: challenges for the twenty-first century. J Clin Oncol 28 (15): 2625-34, 2010. [<a href="/pmc/articles/PMC2881732/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2881732</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20404250" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20404250</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_2">American Academy of Pediatrics: Standards for pediatric cancer centers. Pediatrics 134 (2): 410-4, 2014. <a href="https://pediatrics.aappublications.org/content/134/2/410" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Also available online</a>. Last accessed December 8, 2022.</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_3">Smith MA, Altekruse SF, Adamson PC, et al.: Declining childhood and adolescent cancer mortality. Cancer 120 (16): 2497-506, 2014. [<a href="/pmc/articles/PMC4136455/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4136455</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24853691" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24853691</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_4">National Cancer Institute: NCCR*Explorer: An interactive website for NCCR cancer statistics. Bethesda, MD: National Cancer Institute. <a href="https://NCCRExplorer.ccdi.cancer.gov/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Available online</a>. Last accessed December 6, 2022.</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_5">Surveillance Research Program, National Cancer Institute: SEER*Explorer: An interactive website for SEER cancer statistics. Bethesda, MD: National Cancer Institute. <a href="https://seer.cancer.gov/statistics-network/explorer/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Available online</a>. Last accessed February 13, 2023.</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_6">Ward E, DeSantis C, Robbins A, et al.: Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin 64 (2): 83-103, 2014 Mar-Apr. [<a href="https://pubmed.ncbi.nlm.nih.gov/24488779" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24488779</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_7">Gatta G, Capocaccia R, Botta L, et al.: Burden and centralised treatment in Europe of rare tumours: results of RARECAREnet-a population-based study. Lancet Oncol 18 (8): 1022-1039, 2017. [<a href="https://pubmed.ncbi.nlm.nih.gov/28687376" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28687376</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_8">DeSantis CE, Kramer JL, Jemal A: The burden of rare cancers in the United States. CA Cancer J Clin 67 (4): 261-272, 2017. [<a href="https://pubmed.ncbi.nlm.nih.gov/28542893" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28542893</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_9">Ferrari A, Brecht IB, Gatta G, et al.: Defining and listing very rare cancers of paediatric age: consensus of the Joint Action on Rare Cancers in cooperation with the European Cooperative Study Group for Pediatric Rare Tumors. Eur J Cancer 110: 120-126, 2019. [<a href="https://pubmed.ncbi.nlm.nih.gov/30785015" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30785015</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1864_10">Pappo AS, Krailo M, Chen Z, et al.: Infrequent tumor initiative of the Children's Oncology Group: initial lessons learned and their impact on future plans. J Clin Oncol 28 (33): 5011-6, 2010. [<a href="/pmc/articles/PMC3020699/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3020699</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20956621" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20956621</span></a>]</div></li></ol></div></div><div id="CDR0000790385__1486"><h2 id="_CDR0000790385__1486_">Childhood Laryngeal Papillomatosis</h2><div id="CDR0000790385__1845"><h3>General Information</h3><p id="CDR0000790385__1846">Recurrent respiratory papillomatosis is the most common benign laryngeal tumor in children and is associated with human papillomavirus (HPV) infection, most commonly HPV-6 and HPV-11.[<a class="bk_pop" href="#CDR0000790385_rl_1486_1">1</a>,<a class="bk_pop" href="#CDR0000790385_rl_1486_2">2</a>] The presence of HPV-11 appears to correlate with a more aggressive clinical course than does the presence of HPV-6.[<a class="bk_pop" href="#CDR0000790385_rl_1486_3">3</a>] An Australian survey of pediatric otorhinolaryngologists documented a decline in the incidence of laryngeal papillomatosis after the introduction of HPV vaccinations for adolescent girls and young women aged 12 to 26 years.[<a class="bk_pop" href="#CDR0000790385_rl_1486_4">4</a>] In another study of patients younger than 18 years with laryngeal papillomatosis, the incidence decreased from 165 cases in children born between 2004 and 2005 to 36 cases in children born between 2012 and 2013. The HPV vaccine was released in 2006. The authors of the study attribute the decline in incidence to the widespread use of the vaccine.[<a class="bk_pop" href="#CDR0000790385_rl_1486_5">5</a>]</p><p id="CDR0000790385__1885"> These tumors can cause
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hoarseness because of their association with wart-like nodules on the vocal
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cords, and they may rarely extend into the lung, producing significant morbidity.[<a class="bk_pop" href="#CDR0000790385_rl_1486_6">6</a>] Malignant
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degeneration may occur, with development of cancer in the larynx and squamous cell lung cancer.</p><p id="CDR0000790385__1901">A multi-institutional registry study identified children with juvenile-onset recurrent respiratory papillomatosis from 23 states between January 2015 and August 2020.[<a class="bk_pop" href="#CDR0000790385_rl_1486_7">7</a>] Of the 215 children with juvenile-onset recurrent respiratory papillomatosis, 88.8% were delivered vaginally. Among 190 mothers, the median age at the time of delivery was 22 years. Of 114 mothers (60.0%) who were age-eligible for the HPV vaccination, 16 (14.0%) were vaccinated, 1 (0.9%) of whom was vaccinated before delivery. Of 162 tested biopsy specimens, 157 (96.9%) had detectable HPV. All 157 specimens had a vaccine-preventable HPV type.
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</p></div><div id="CDR0000790385__1847"><h3>Treatment of Childhood Laryngeal Papillomatosis</h3><p id="CDR0000790385__1848">Papillomatosis is not
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cancerous, and primary treatment is surgical ablation with laser vaporization.[<a class="bk_pop" href="#CDR0000790385_rl_1486_8">8</a>] Frequent recurrences are common. Lung involvement, although rare, can occur.[<a class="bk_pop" href="#CDR0000790385_rl_1486_6">6</a>]</p><p id="CDR0000790385__1909">Evidence (surgery):</p><ol id="CDR0000790385__1910"><li class="half_rhythm"><div>A single-institution retrospective analysis evaluated 121 children with respiratory papillomatosis. The age at initial operation was 4.3 years (±2.9 years), and 47.9% of patients (58 of 121) experienced a recurrence and underwent surgical treatment after the age of 14 years.[<a class="bk_pop" href="#CDR0000790385_rl_1486_9">9</a>]<ul id="CDR0000790385__1911"><li class="half_rhythm"><div> At follow-up, 5% of the patients (6 of 121) had died, 41.3% of the patients (50 of 121) had been recurrence free for 5 years or longer (cured group), and 53.7% of the patients (65 of 121) experienced a recurrence in the previous 5 years (recurrent group). </div></li><li class="half_rhythm"><div>There were no significant differences in sex, age at initial operation, or adjuvant therapy between the cured and recurrent groups of patients. </div></li><li class="half_rhythm"><div>In the recurrent group, there was a higher incidence of overall operation frequency, aggressive disease, tracheal dissemination of papilloma, and HPV infection.</div></li></ul></div></li></ol><p id="CDR0000790385__1886">If a patient requires more than four surgical procedures per year, other interventions may be necessary, including the following:</p><ul id="CDR0000790385__1849"><li class="half_rhythm"><div>Interferon therapy.[<a class="bk_pop" href="#CDR0000790385_rl_1486_10">10</a>]</div></li><li class="half_rhythm"><div>Immunotherapy with HspE7, a recombinant fusion protein that has shown activity in other HPV-related diseases. A pilot study suggested a marked increase in the amount of time between surgeries.[<a class="bk_pop" href="#CDR0000790385_rl_1486_11">11</a>]</div></li><li class="half_rhythm"><div>Laser therapy combined with intralesional bevacizumab.[<a class="bk_pop" href="#CDR0000790385_rl_1486_12">12</a>]</div></li></ul><p id="CDR0000790385__1850">The effectiveness of intralesional cidofovir has not been conclusively demonstrated.[<a class="bk_pop" href="#CDR0000790385_rl_1486_13">13</a>]</p><p id="CDR0000790385__1874">The role of checkpoint inhibitors, such as PD-1 inhibitors, is currently being investigated.[<a class="bk_pop" href="#CDR0000790385_rl_1486_14">14</a>] Reports with small numbers of patients have documented that in selected cases, the administration of a quadrivalent HPV vaccine can be associated with a complete remission and an increase in the intersurgical interval.[<a class="bk_pop" href="#CDR0000790385_rl_1486_15">15</a>,<a class="bk_pop" href="#CDR0000790385_rl_1486_16">16</a>] In contrast, other reports have not documented a therapeutic effect of the quadrivalent HPV vaccine.[<a class="bk_pop" href="#CDR0000790385_rl_1486_17">17</a>]</p><p id="CDR0000790385__1894">In a report of two patients with aggressive recurrent respiratory papillomatosis, treatment with systemic bevacizumab produced good results with minimal toxicity.[<a class="bk_pop" href="#CDR0000790385_rl_1486_18">18</a>]</p></div><div id="CDR0000790385__1875"><h3>Treatment Options Under Clinical Evaluation for Childhood Laryngeal Papillomatosis</h3><p id="CDR0000790385__1876">Information about National Cancer Institute (NCI)–supported clinical trials can be found on the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>. For information about clinical trials sponsored by other organizations, see the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov website</a>.</p></div><div id="CDR0000790385_rl_1486"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000790385_rl_1486_1">Kashima HK, Mounts P, Shah K: Recurrent respiratory papillomatosis. Obstet Gynecol Clin North Am 23 (3): 699-706, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8869953" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8869953</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_2">Derkay CS, Wiatrak B: Recurrent respiratory papillomatosis: a review. Laryngoscope 118 (7): 1236-47, 2008. [<a href="https://pubmed.ncbi.nlm.nih.gov/18496162" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18496162</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_3">Maloney EM, Unger ER, Tucker RA, et al.: Longitudinal measures of human papillomavirus 6 and 11 viral loads and antibody response in children with recurrent respiratory papillomatosis. Arch Otolaryngol Head Neck Surg 132 (7): 711-5, 2006. [<a href="https://pubmed.ncbi.nlm.nih.gov/16847177" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16847177</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_4">Novakovic D, Cheng ATL, Zurynski Y, et al.: A Prospective Study of the Incidence of Juvenile-Onset Recurrent Respiratory Papillomatosis After Implementation of a National HPV Vaccination Program. J Infect Dis 217 (2): 208-212, 2018. [<a href="https://pubmed.ncbi.nlm.nih.gov/29136168" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29136168</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_5">Meites E, Stone L, Amiling R, et al.: Significant Declines in Juvenile-onset Recurrent Respiratory Papillomatosis Following Human Papillomavirus (HPV) Vaccine Introduction in the United States. Clin Infect Dis 73 (5): 885-890, 2021. [<a href="/pmc/articles/PMC8380742/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8380742</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33621333" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33621333</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_6">Gélinas JF, Manoukian J, Côté A: Lung involvement in juvenile onset recurrent respiratory papillomatosis: a systematic review of the literature. Int J Pediatr Otorhinolaryngol 72 (4): 433-52, 2008. [<a href="https://pubmed.ncbi.nlm.nih.gov/18281102" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18281102</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_7">Amiling R, Meites E, Querec TD, et al.: Juvenile-Onset Recurrent Respiratory Papillomatosis in the United States, Epidemiology and HPV Types-2015-2020. J Pediatric Infect Dis Soc 10 (7): 774-781, 2021. [<a href="/pmc/articles/PMC8446313/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8446313</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34145881" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34145881</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_8">Andrus JG, Shapshay SM: Contemporary management of laryngeal papilloma in adults and children. Otolaryngol Clin North Am 39 (1): 135-58, 2006. [<a href="https://pubmed.ncbi.nlm.nih.gov/16469660" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16469660</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_9">Xiao Y, Zhang X, Ma L, et al.: Long-term outcomes of juvenile-onset recurrent respiratory papillomatosis. Clin Otolaryngol 46 (1): 161-167, 2021. [<a href="https://pubmed.ncbi.nlm.nih.gov/32815263" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32815263</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_10">Avidano MA, Singleton GT: Adjuvant drug strategies in the treatment of recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg 112 (2): 197-202, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7530830" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7530830</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_11">Derkay CS, Smith RJ, McClay J, et al.: HspE7 treatment of pediatric recurrent respiratory papillomatosis: final results of an open-label trial. Ann Otol Rhinol Laryngol 114 (9): 730-7, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/16240938" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16240938</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_12">Sidell DR, Nassar M, Cotton RT, et al.: High-dose sublesional bevacizumab (avastin) for pediatric recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol 123 (3): 214-21, 2014. [<a href="https://pubmed.ncbi.nlm.nih.gov/24633948" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24633948</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_13">Chadha NK, James A: Adjuvant antiviral therapy for recurrent respiratory papillomatosis. Cochrane Database Syst Rev 12: CD005053, 2012. [<a href="/pmc/articles/PMC7208975/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7208975</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23235619" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23235619</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_14">Ivancic R, Iqbal H, deSilva B, et al.: Current and future management of recurrent respiratory papillomatosis. Laryngoscope Investig Otolaryngol 3 (1): 22-34, 2018. [<a href="/pmc/articles/PMC5824106/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5824106</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29492465" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29492465</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_15">Young DL, Moore MM, Halstead LA: The use of the quadrivalent human papillomavirus vaccine (gardasil) as adjuvant therapy in the treatment of recurrent respiratory papilloma. J Voice 29 (2): 223-9, 2015. [<a href="https://pubmed.ncbi.nlm.nih.gov/25619468" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25619468</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_16">Mészner Z, Jankovics I, Nagy A, et al.: Recurrent laryngeal papillomatosis with oesophageal involvement in a 2 year old boy: successful treatment with the quadrivalent human papillomatosis vaccine. Int J Pediatr Otorhinolaryngol 79 (2): 262-6, 2015. [<a href="https://pubmed.ncbi.nlm.nih.gov/25496821" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25496821</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_17">Katsuta T, Miyaji Y, Offit PA, et al.: Treatment With Quadrivalent Human Papillomavirus Vaccine for Juvenile-Onset Recurrent Respiratory Papillomatosis: Case Report and Review of the Literature. J Pediatric Infect Dis Soc 6 (4): 380-385, 2017. [<a href="https://pubmed.ncbi.nlm.nih.gov/28992265" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28992265</span></a>]</div></li><li><div class="bk_ref" id="CDR0000790385_rl_1486_18">Carnevale C, Ferrán-De la Cierva L, Til-Pérez G, et al.: Safe use of systemic bevacizumab for respiratory recurrent papillomatosis in two children. Laryngoscope 129 (4): 1001-1004, 2019. [<a href="https://pubmed.ncbi.nlm.nih.gov/30588638" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30588638</span></a>]</div></li></ol></div></div><div id="CDR0000790385__1851"><h2 id="_CDR0000790385__1851_">Changes to This Summary (12/08/2022)</h2><p id="CDR0000790385__1852">The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.</p><p id="CDR0000790385__2421">
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<b>
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<a href="#CDR0000790385__1864">Special Considerations for the Treatment of Children With Cancer</a>
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</p><p id="CDR0000790385__2422">Revised <a href="#CDR0000790385__1869">text</a> to state that between 1975 and 2020, childhood cancer mortality decreased by more than 50% (cited National Cancer Institute as reference 4 and Surveillance Research Program, National Cancer Institute as reference 5).</p><p id="CDR0000790385__2423">Revised <a href="/books/NBK475829.13/#CDR0000790385__1871">text</a> to state that rare pediatric cancers account for about 5% of the cancers diagnosed in children aged 0 to 14 years and about 27% of the cancers diagnosed in adolescents aged 15 to 19 years. Also revised text to state that most cancers in subgroup XI are either melanomas or thyroid cancers, with other cancer types accounting for only 2% of the cancers in children aged 0 to 14 years and 9.3% of cancers in adolescents aged 15 to 19 years.</p><p id="CDR0000790385__1912">
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<b>
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<a href="#CDR0000790385__1486">Childhood Laryngeal Papillomatosis</a>
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</p><p id="CDR0000790385__1914">Added <a href="#CDR0000790385__1846">text</a> to state that in another study of patients younger than 18 years with laryngeal papillomatosis, the incidence decreased from 165 cases in children born between 2004 and 2005 to 36 cases in children born between 2012 and 2013. The HPV vaccine was released in 2006. The authors of the study attribute the decline in incidence to the widespread use of the vaccine (cited Meites et al. as reference 5).</p><p id="CDR0000790385__disclaimerHP_3">This summary is written and maintained by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/pediatric-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Pediatric Treatment Editorial Board</a>, which is
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editorially independent of NCI. The summary reflects an independent review of
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the literature and does not represent a policy statement of NCI or NIH. More
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information about summary policies and the role of the PDQ Editorial Boards in
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maintaining the PDQ summaries can be found on the <a href="#CDR0000790385__AboutThis_1">About This PDQ Summary</a> and <a href="https://www.cancer.gov/publications/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ® Cancer Information for Health Professionals</a> pages.
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</p></div><div id="CDR0000790385__AboutThis_1"><h2 id="_CDR0000790385__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000790385__AboutThis_2"><h3>Purpose of This Summary</h3><p id="CDR0000790385__AboutThis_3">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of childhood laryngeal cancer and papillomatosis. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions.</p></div><div id="CDR0000790385__AboutThis_4"><h3>Reviewers and Updates</h3><p id="CDR0000790385__AboutThis_5">This summary is reviewed regularly and updated as necessary by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/pediatric-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Pediatric Treatment Editorial Board</a>, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p><p id="CDR0000790385__AboutThis_22"> Board members review recently published articles each month to determine whether an article should:</p><ul id="CDR0000790385__AboutThis_6"><li class="half_rhythm"><div>be discussed at a meeting,</div></li><li class="half_rhythm"><div>be cited with text, or</div></li><li class="half_rhythm"><div>replace or update an existing article that is already cited.</div></li></ul><p id="CDR0000790385__AboutThis_7">Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.</p><p>The lead reviewers for Childhood Laryngeal Tumors Treatment are:</p><ul><li class="half_rhythm"><div>Denise Adams, MD (Children's Hospital Boston)</div></li><li class="half_rhythm"><div>Karen J. Marcus, MD, FACR (Dana-Farber Cancer Institute/Boston Children's Hospital)</div></li><li class="half_rhythm"><div>William H. Meyer, MD (University of Oklahoma Health Sciences Center)</div></li><li class="half_rhythm"><div>Paul A. Meyers, MD (Memorial Sloan-Kettering Cancer Center)</div></li><li class="half_rhythm"><div>Thomas A. Olson, MD (Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta - Egleston Campus)</div></li><li class="half_rhythm"><div>Alberto S. Pappo, MD (St. Jude Children's Research Hospital)</div></li><li class="half_rhythm"><div>Arthur Kim Ritchey, MD (Children's Hospital of Pittsburgh of UPMC)</div></li><li class="half_rhythm"><div>Carlos Rodriguez-Galindo, MD (St. Jude Children's Research Hospital)</div></li><li class="half_rhythm"><div>Stephen J. Shochat, MD (St. Jude Children's Research Hospital)</div></li></ul><p id="CDR0000790385__AboutThis_9">Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.</p></div><div id="CDR0000790385__AboutThis_10"><h3>Levels of Evidence</h3><p id="CDR0000790385__AboutThis_11">Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Pediatric Treatment Editorial Board uses a <a href="/books/n/pdqcis/CDR0000062796/">formal evidence ranking system</a> in developing its level-of-evidence designations.</p></div><div id="CDR0000790385__AboutThis_12"><h3>Permission to Use This Summary</h3><p id="CDR0000790385__AboutThis_13">PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary].”</p><p id="CDR0000790385__AboutThis_14">The preferred citation for this PDQ summary is:</p><p id="CDR0000790385__AboutThis_15">PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Laryngeal Tumors Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/head-and-neck/hp/child/laryngeal-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/head-and-neck/hp/child/laryngeal-treatment-pdq</a>. Accessed <MM/DD/YYYY>. </p><p id="CDR0000790385__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>, a collection of over 2,000 scientific images.
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</p></div><div id="CDR0000790385__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000790385__AboutThis_18">Based on the strength of the available evidence, treatment options may be described as either “standard” or “under clinical evaluation.” These classifications should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000790385__AboutThis_20"><h3>Contact Us</h3><p id="CDR0000790385__AboutThis_21">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK475829.13/?report=reader">PubReader</a></li><li><a href="/books/NBK475829.13/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK475829" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK475829" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Pediatric Treatment Editorial Board. Childhood Laryngeal Tumors Treatment (PDQ®): Health Professional Version. 2022 Dec 8. In: PDQ Cancer Information Summaries [Internet]. 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Considerations for the Treatment of Children With Cancer</a></li><li><a href="#CDR0000790385__1486" ref="log$=inpage&link_id=inpage">Childhood Laryngeal Papillomatosis</a></li><li><a href="#CDR0000790385__1851" ref="log$=inpage&link_id=inpage">Changes to This Summary (12/08/2022)</a></li><li><a href="#CDR0000790385__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK475823/">Patient Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div 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title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389189" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Laryngeal Cancer Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Laryngeal Cancer Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389243" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Rhabdomyosarcoma Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Rhabdomyosarcoma Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" 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xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Esthesioneuroblastoma Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=29337477" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=29337477" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div 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