Radical X-ray Treatment of Malignancy in the Larynx and Pharynx

Abstract

Before commencing radiotherapy in a case of throat carcinoma, first of all the fullest possible clinical diagnosis should be made, as to site, origin of lesion, and probable extent of invasion. For this, and throughout the course of treatment, the co-operation of a laryngologist is essential. Examinations may be needed by direct laryngoscopy, or by œsophagoscopy; and the question of a preliminary tracheotomy may have to be considered before or during treatment, specially in advanced cases, when the airway is already narrowed and reactionary œdema of the glottis might be dangerous. Secondly, preliminary X-ray examinations should be undertaken to show: (1) the condition of the cartilages as to invasion or not; (2) the soft tissues, specially in the lateral view; e.g., of the prevertebral area in post-cricoid cases; (3) the upper œsophagus (in several obliquities with a barium bolus); (4) the cervical vertebrae (I have seen one case of metastasis from the larynx to the cervical spine); and (5) the chest, as i...