Deficits in irradiation therapy for carcinoma of the larynx followed by surgery.

Abstract

A detailed analysis was made in 23 patients, and the results of 288 other cases surveyed, with respect to the optimal field size and the ensuing complications of presurgical irradiation of laryngeal cancer. Two types of radiation therapy were used: 220 kv (conventional apparatus) and 2 Mev (Van de Graaff electrostatic generator). All 23 cases received 38 treatments over a period of,8 weeks using a port as small as possible, to allow for the fact that surgery might be done later. In none of the cases was a larger port than 8 x 10 cm used. The total x-ray tumor dose varied between 8000 and 7000 r, and when 2 Mev electrons were used the dosage varied between 5000 and 6000 r. The complications as a result of irradiation except in three cases were not great, and it is doubtful if the end results would have been better had surgery been performed initially on those in whom radiation necrosis took place. There was little or no difference in the response of the tissues to surgery to 220-kv x rays and 2-Mev electrons when the tumor dose was the same.