title: Radionecrosis or tumor recurrence after radiation of laryngeal and hypopharyngeal carcinomas.
abstract: 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.
authors.affiliation: Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital, Berne, Switzerland. peter.zbaeren@insel.ch
authors.forename: Peter
authors.initials: P
authors.lastname: Zbären
authors.forename: Marco
authors.initials: M
authors.lastname: Caversaccio
authors.forename: Harriet C
authors.initials: HC
authors.lastname: Thoeny
authors.forename: Michel
authors.initials: M
authors.lastname: Nuyens
authors.forename: Jürgen
authors.initials: J
authors.lastname: Curschmann
authors.forename: Edouard
authors.initials: E
authors.lastname: Stauffer
mesh_terms: 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