Document Detail


Glottic carcinoma--patterns of failure and salvage treatment after curative radiotherapy in 861 consecutive patients.
MedLine Citation:
PMID:  12142089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The aim of this study was to evaluate the patterns of failure and the treatment of recurrences, in a series of primary irradiated patients with squamous cell carcinoma of the glottic larynx. MATERIALS AND METHODS: Eight hundred and sixty-one consecutive patients were included in this study from 1963 to 1991, out of which 74 were females and 787 males. The stages were: I 56, II 26, III 15, and IV 3%. In 847 of 861 cases (98%) the primary treatment was delivered with curative intent, and out of these 834 patients received primary radical radiotherapy. RESULTS: With a minimum follow up of 5 years, 274/861(32%) patients had persistent or recurrent disease; in 91% of these the persistent or recurrent disease was in the T-position, 15% in the N-position, and 5% developed distant metastases. Curative salvage attempt was possible in 207 patients, and 145 were subsequently controlled. A total of 718 (83%) patients obtained ultimate tumour control, 584 (68%) without a laryngectomy (134 of the controlled had a laryngectomy, 109 had a total laryngectomy and 25 had a partial laryngectomy). In the patients treated with curative intent, the overall 5-year local tumour control, loco-regional tumour control, disease specific survival rate and overall survival rate was 72, 70, 86 and 66%, respectively. For patients with small tumours the disease specific survival for T1a, T1b and T2 was 95, 93 and 83%, respectively. In the 718 patients cured for their glottic carcinoma, 204 new primary malignant tumours were detected. CONCLUSIONS: The study shows that laryngeal glottic carcinoma can be effectively managed by primary radiotherapy and surgery salvage. The control is obtained with a high proportion of laryngeal preservation (68%). Recurrences treated with surgical salvage have a success rate of 70%. New primaries are a major problem.
Authors:
Lars Vendelbo Johansen; Cai Grau; Jens Overgaard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology     Volume:  63     ISSN:  0167-8140     ISO Abbreviation:  Radiother Oncol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-07-26     Completed Date:  2002-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8407192     Medline TA:  Radiother Oncol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  257-67     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Elsevier Science Ireland Ltd.
Affiliation:
Department of Experimental Clinical Oncology, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Carcinoma, Squamous Cell / mortality,  radiotherapy*
Female
Glottis*
Humans
Laryngeal Neoplasms / mortality,  radiotherapy*
Male
Neoplasm Recurrence, Local / radiotherapy,  surgery
Neoplasm Staging
Palliative Care
Prognosis
Salvage Therapy
Survival Rate
Tracheotomy
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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