Radionecrosis or tumor recurrence after radiation of laryngeal and hypopharyngeal carcinomas.
OBJECTIVE
To analyze the incidence and diagnostic difficulties of radionecrosis vs tumor recurrence of laryngeal and hypopharyngeal carcinomas.


METHODS
Retrospective study on 341 patients treated by radiation alone or radiochemotherapy. The clinicopathologic findings, work-up, treatment, and follow-up of 20 patients with symptoms suggestive but negative for tumor recurrence on initial imaging studies and endoscopy were analyzed.


RESULTS
The incidence of chondroradionecrosis in 341 irradiated patients was 5%. Ten of 20 patients initially negative for tumor recurrence were treated by total laryngectomy; in all laryngectomy specimens, chondroradionecrosis was present, in six specimens associated with tumor recurrence. Ten patients were treated by tracheotomy and tumor recurrence was detected in one patient during follow-up.


CONCLUSIONS
Chondroradionecrosis is a relatively rare treatment complication. Typical imaging findings suggestive of radionecrosis are often missing. Tumor recurrence may be present beneath an intact mucosa and missed by endoscopy.
Zbären
Peter
P
Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital, Berne, Switzerland. peter.zbaeren@insel.ch
Caversaccio
Marco
M
Thoeny
Harriet C
HC
Nuyens
Michel
M
Curschmann
Jürgen
J
Stauffer
Edouard
E
D003131:Combined Modality Therapy; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D007825:Laryngectomy / Q000706:statistics & numerical data; D007828:Laryngoscopy; D008279:Magnetic Resonance Imaging; D009336:Necrosis / Q000209:etiology; D009364:Neoplasm Recurrence, Local; D011832:Radiation Injuries / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014140:Tracheotomy / Q000706:statistics & numerical data