[Laser-radiation therapy for T2N0M0 laryngeal-glottic cancer].
OBJECTIVE
To evaluate the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer in order to preserve the larynx.


METHODS
The subjects consisted of 52 patients with T2N0M0 laryngeal-glottic cancer treated with laser-radiation combined therapy between 1980 and 1999. Patients ranged in age from 40-88 years, with a median of 70 years, and included 51 men and one woman. During this period, treatment was administered with different radiation devices(60Co or 4 MV-X ray), and 40-72 Gy (median, 60 Gy) of radiation therapy ware administered. Tumor and treatment characteristics were correlated with local control at a median follow-up of 61 months(range 12-210 months). Concurrent chemotherapy was administered to 32 patient; 29 were treated with 5-FU and vitamin A(FAR), and 3 were treated with low-dose CDDP. Post treatment vocal function was examined in 37 patients. The voice was evaluated in terms of four parameters: maximum phonation time (MPT), mean air flow rate during phonation over a comfortable duration(MFR), fundamental frequency range of phonation(F0 range), and sound pressure level range of phonation (SPL range).


RESULTS
The five-year cause-specific-survival rate was 98.0%, and the local control rate was 91.8%. Three of 4 patients who had locally relapsed were administered total laryngectomy as salvage therapy. One patient was administered the tracheostomy for late complication. The actuarial laryngeal preservation rate was 92.3%. We did not find any significant relationship between local relapse and extent of disease, subglottic extension, or anterior commissure involvement. Concurrent chemotherapy was not a significant prognostic factor. Laser debulking followed by radiation therapy did not change the voice significantly except the F0 range.


CONCLUSIONS
We conclude that the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer was effective therapy for not only preservation of the voice but also for vocal function.
Suzuki
Gen
G
Department of Radiology, School of Medicine, Kurume University.
Hayabuchi
Naofumi
N
Toda
Yukihiro
Y
Suefuji
Hiroaki
H
Ogo
Etuyo
E
Nakajima
Tadashi
T
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000628:therapy*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage