Long-term results and cause of failure analysis in larynx cancer patients irradiated conventionally and with accelerated fractionation schedules in 1995 – 1998
Journal Title: Otolaryngologia Polska - Year 2014, Vol 68, Issue 6
Abstract
The clinical material consists of 217 patients with squamous cell carcinoma in supraglottic and glottic larynx in clinical stage T1– 3N0M0 irradiated radi cally in Warsaw Oncology Centre in 1995–1998. All patients were treated with Co-60, according to two schedules of fractionation, with maintenance of the consistent thera peutic protocol. The same team of doctors worked on the treatment of patients and on the follo w-up as well. The clinical material is a part of a three-ph ased clinical trial KBN 0295. In the course of observation, the progre ssion of cancer was not observed in 157 patients, among whom, 66% were treated conventionally and 79% with accelerated fractio nation method. 60 cases of locoregional recurrences were noted, among which 55 were regional. The majority of failure cases was observed until the 30th of the month after the radiotherapy ended. In conventional fractionation treatment, recurrences in T1 were 8/31 (26%), in T2 22/59 (37%) and in T3 8/20 (40%). In patients treated with AF, recurrences were T1 5/39 (13%), T2 15/55 (27%) and T3 2/13 (15%) respectively. The percentage of primary site tumour recurrences for each localization and kind of treatment was analysed. In CF 28/78 (37%) of glottic tumour recurrences and 10/34 (29%) of supraglottic tumour, recurrences were observed. In AF, 12/71 (17%) and 10/36 (28%) were observed respectively. In 48 cases salvage surgery was used, and 12 patients were not qualified because of tumour massive progression or because they refused to have a surgery. Among 34 cases (16%) of the second primary tumour or distant methastases, 25 were observed with glottic cancer, among which 23 were observed in early stages, and 9 cases with supraglottic cancer, among which, 6 showed early stage of tumour. In only 3 cases out of all the patients, distant methastases were confirmed in histopatology examination. The main cause of failure in larynx cancer patients in stage T1 is that 3N0M0 are local recurrences. Second primary or distant methastases constitute 16% of the patients in this paper.
Authors and Affiliations
Zbigniew Szutkowski, Andrzej Kawecki
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