Abstract
SummaryIn early stage (I and II) laryngeal squamous cell carcinoma, both surgery and radiotherapy results in significant local and regional control. In advanced tumors (III and IV), radiotherapy alone has local-regional control rates of 32-43%.AimTo assess disease-free survival in SCC laryngeal carcinoma patients submitted to radiotherapy alone and/or associated with chemotherapy.Materials and MethodsRetrospective study involving 84 cases of laryngeal SCC treated with radiotherapy or chemotherapy together with radiotherapy. Fifty-three cases were treated with intension to cure and 31 because of impossibility to resect the disease. As to clinical stage (CS), 12 were CS I, 15 II, 21 III and 5 IV. In the second group, 11 cases were EC III and 20 IV.ResultsMean age was 60 years, 84.5% were men. Fifty-eight (69.1%) cases had complete response and 26 (30.9%) had persistent or residual disease. Five-year disease-free survival was of 42.5%; 62.5% of the patients with organ preservation indication and 9.75 in the group of irressecable disease.Conclusiondisease-free survival of those patients submitted to radiotherapy because of laryngeal SCC was of 62.5%
Highlights
Patients with initial stage (I and II) laryngeal squamous cell carcinoma benefit from surgery and radiotherapy, showing significant rates of local and regional control and preserved speech, swallowing and breathing.[1,2] The results in such early cases are similar when using surgery or radiotherapy for local and regional control; rates are close to 100% for T1 tumors, and range from 55% to 75% for T2 tumors
Often after radiotherapy permanent fibrosis of the lamina propria may develop, which compromises the ability of the vocal fold to vibrate because of its need to be whole for proper function
We indicate one to three cycles of cisplatin (CDDP) at 100 mg/ m2 if neoadjuvant chemotherapy is initiated; in this case, a third of the dose is given in the first three days (D1, 2, 3), 450 mg/m2 (D1-5) 5-fluorouracil (5FU) and 135 mg/ m2 (D1) paclitaxel
Summary
Patients with initial stage (I and II) laryngeal squamous cell carcinoma benefit from surgery and radiotherapy, showing significant rates of local and regional control and preserved speech, swallowing and breathing.[1,2] The results in such early cases (stages I and II) are similar when using surgery or radiotherapy for local and regional control; rates are close to 100% for T1 tumors, and range from 55% to 75% for T2 tumors. The assumption that voice quality - especially in T1 tumors - benefits more from radiotherapy than from surgery is not completely true. Acceptable recovery of voice, is possible in poorly infiltrated T1 tumors treated surgically (cordectomy); in this situation, scarring results in a similar structure to the vocal fold, which may even vibrate. The literature shows that better results in voice quality are seen in patients submitted to organ-sparing protocols, compared to surgery.[3]
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