2Dokuz Eylül Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Anabilim Dalı, İzmir
3Dokuz Eylül Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı, İzmir OBJECTIVES
The aim of this study was to evaluate the treatment results retrospectively in early stage larynx carcinoma treated with definitive radiotherapy (RT) according to the treatment protocol of Dokuz Eylül Head and Neck Cancer Group (DEHNCG).
METHODS
Between July 1991 and June 2004, 144 patients (138 males (%96), 6 (%4) females; median age 61; range 27 to 87 years) with early stage squamous-cell carcinoma of the larynx were treated with definitive RT at our institution. According to DEHNCG protocol stage I and inoperabl (poor performance status, comorbidity or patient choice) stage II larynx carcinomas are treated with definitive radiotherapy. Definitive RT is applied with megavoltage (6 MV-X or Co60), parallel- opposed beams with wedge filters. Before RT all patients were simulated and a computerized system was used for treatment planning. RTOG/EORTC scale was used for documentation of early and late side effects. Survival analysis have been calculated with Kaplan- Meier method.
RESULTS
The majority of the patients were men (96%). One hundred and eleven (77%) patients had squamous cell carcinoma and 32 (22%) had carcinoma in situ. Clinically 32 (22%), 86 (60%) and 26 (%18) patients were evaluated as Tis, T1 and T2 larynx carcinoma respectively. All patients completed the planned treatment. Median dose was 66 (50-70) Gy. There were no grade III or IV early side effects. Grade III skin, larynx and cartilage late side effects were seen in 3 (2%) patients. Median follow up was 68 (4–162) months. Two, 5 and 10 years overall survival rates were 94%, 85% and 65% respectively. Loco-regional progression free survivals for 2, 5 and 10 years were 90%, 87% and 87% respect ively. Eighteen (12.5%) of 144 patients had loco-regional failure and 14 of them had salvage surgery. Five years disease spesific survival for Tis, T1 and T2 were 95%, 96% and 94% respectively. Five years voice preserving rates for Tis and T1 were 97% and 89% for T2 patients.
CONCLUSION
Definitive RT is an organ preserving and an effective treatment method in patients with early stage glottic carcinoma. High local control and survival rates can be obtained with salvage treatments after the locoregional failures after definitive RT.