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• W2184232611 abstract "Introductions . The aim of the study was to assess the efficacy of radiotherapy alone in patients with locally advanced laryngeal cancer T3-T4, and to establish the prognostic value of the size and the location of the extralaryngeal infiltrations and of emergency tracheostomy. Material and methods. 296 patients with advanced squamous cell cancer of the larynx were radically treated with radiotherapy alone in Center of Oncology in Gliwice between the years 1990 and 1996. There were 221 cases of supraglottic cancer (75%) and 75 of glottic cancer (25%). The stages were as follows: supraglottic cancer: T3 – 113 (51%), T4 – 108 (49%), glottic cancer: T3 – 69 (92%), T4 – 6 (8%). Positive neck nodes were found in 100 patients with supraglottic cancer (45%), and only in 11 patients with glottic cancer (15%). In cases of extralaryngeal invasion (T4) the pyriform recess was involved in 33%, the base of tongue and valleculae glosso-epiglotticae in 30%, the hypopharyngeal wall in 9% of cases, while a massive involvement of the larynx, the pyriform recess and the base of the tongue was found in 6% of patients. Cartilage involvement was suspected in 22% of patients. Thirty six patients (12%) underwent emergency tracheostomy. Results . Generally, the 3-year local control rate (LC) and disease free survival rate (DSF) were 46% and 41%, respectively. The probability of LC was similar in both supraglottic and glottic cancer: 44% and 47.5% respectively. The presence of involved neck nodes significantly decreased LC and DFS rates in both groups (about 20%). For stage T4 laryngeal cancer the LC rate was correlated with the location of the extralaryngeal infiltrations. Best prognosis was connected with the suspicion of cartilage infiltration – 56% of 3-year LC rate. The worst results were noted in cases of massive infiltrations spreading from larynx through the hypopharynx – 13.5% of 3-year LC rate. Emergency tracheostomy before radiotherapy was very significantly linked to poorer treatment results. The 3-year LC rate in tracheostomy patients was 6%, as comparied to 51% in other patients. Multivariate analysis using Cox regression model showed that the worst prognosis was significantly and independently connected with the necessity of emergency tracheostomy before treatment, and neck lymph node involvement. Conclusion s. Conventional radiotherapy of advanced laryngeal cancer has limited effiacy as a method of radical treatment. Emergency tracheostomy and the involvement of neck lymph nodes are poor prognostic factors in the case of patients with advanced laryngeal cancer treated with radiotherapy alone. The efficacy of radiotherapy in stage T4 laryngeal cancer is directly connected with the localisation and the extent of extralaryngeal infiltrations." @default.
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• W2184232611 date "2001-01-01" @default.
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• W2184232611 title "Radiotherapy of locally advanced laryngeal cancer: the Gliwice Center of Oncology experience, 1990-1996" @default.
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