[Adjuvant radiotherapy of the neck lymph modes in patients after partial laryngectomies].
Adjuvant radiotherapy after partial laryngectomy is still controversial mainly due to high level morbidities which may occur in the irradiated larynx. The aim of this study was to evaluate the results (locoregional control) and toxicities (acute and late) of combined treatment. Between 1996 and 2001 the group of 14 patients (12 men, 2 women), aged less than 60 years, Karnofsky scale > 70, were investigated retrospectively. The following surgical procedures were carried out: cricohyoidopexy (CHP) and cricohyoidoepiglottopexy (CHEP) in 9 out of 14 patients, horizontal laryngectomy in 1 patient, fronto-lateral laryngectomy in 4 patients. In all cases diagnosis of squamous cell carcinoma was confirmed. According to pathological classification the stage of disease in the neck was as follows: N1 = 8 patients and N2 = 6 patients. Indications for adjuvant radiotherapy were a high risk of microscopic spread of disease and expectation of regular follow-up problems in treated patients. The main rule of radiotherapy technique was avoiding the irradiation of the preserved larynx. All patients were irradiated postoperatively in conventional way to the elective dose of 50 Gy to the neck with additional dose of 16 Gy to the area of high risk of local recurrence. During follow-up no patients had locoregional failure. The toxicities (early and late) concerned the skin and mucosa of pharynx. These toxicities, evaluated according to the RTOG scale, in all cases were less than III grade. We conclude that combination of partial laryngectomy and postoperative radiotherapy with protection of the larynx during irradiation in the group of patients with high risk of regional recurrence plays an important role in decrease of treatment failures and permits preservation of laryngeal function without any significant side effects. Therefore the described method is an effective treatment for selected patients with the carcinoma of the larynx.
Milecki
Piotr
P
Zakład Radioterapii Wielkopolskiego Centrum Onkologii w Poznaniu. piotr.milecki@wco.pl
Kruk-Zagajewska
Aleksandra
A
Nowak
Katarzyna
K
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000601:surgery*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008198:Lymph Nodes / Q000528:radiation effects*; D008207:Lymphatic Metastasis / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009333:Neck; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome