title: [A new insight into the stage-by-stage combined treatment of T3-4N1-3M0 laryngeal and laryngopharyngeal cancer].
abstract: We have undertaken analysis of postoperative wound healing in 84 patients operated for the treatment of laryngeal and laryngopharyngeal cancer at the Department of Otorhinolaringology, Yaroslavl' State Medical Academy, in 2004-2007. In the group of patients who underwent surgery for laryngeal and laryngopharyngeal cancer following distant gamma-therapy, 56.7% of the cases suffered complications of the wound healing process compared with 16.5% among patients with postoperative irradiation of the wound. Distant gamma-therapy at a cumulative focal dose of 40-46 Gy applied as the first stage of combined treatment in patients with laryngeal and laryngopharyngeal cancer followed by laryngectomy and cervical lymphodissection was associated with the impaired ability of the wound tissue to develop <<physiological>> inflammation. Oncological effectiveness of the treatment was characterized by low percentage of relapse-free cases during the 3-year follow-up period (56.1%). A change in the sequence of treatment procedures (application of gamma-therapy in the postoperative period) resulted in the lowered rate of wound healing complications (16.5%). These findings give reason to regard the two strategies as the methods of choice for the treatment of laryngeal and laryngopharyngeal cancer giving preference to the latter variant with the use of post-surgery gamma-therapy.
authors.forename: V V
authors.initials: VV
authors.lastname: Vinogradov
authors.forename: A L
authors.initials: AL
authors.lastname: Klochikhin
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods / Q000639:trends; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D010611:Pharyngectomy / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome