Combined High Dose Radiation Therapy and Surgery of Advanced Cancer of the Laryngopharynx

Silverstone, Sidney M.; Goldman, Jessica; Ryan, J.F.

doi:10.1159/000387020

Cited by 4 publications

(3 citation statements)

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“…In the present series minimum numbers of complications were in those cases who had surgery after 1 year of completion of RT, which does not corroborate with the recommendation of Silverstone and Associates. 20 Ketcham et al also found distressing results after performing surgery on subjects within 24 hours of completion of RT in a single dose. 21 Though none of the patients in the present series were radiated upon in a single dose, yet a complication rate of 33.33% was found in the patients who had operation within 2 weeks of completion of RT corroborating the conclusions of Ketchem et al…”

Section: Discussionmentioning

confidence: 98%

“…19 Silverstone and Associates recommend an interval of 21 to 42 days. 20 Their contention is that for the most tissues 3 weeks interval after cancerocidal doses is minimal and 6 weeks is probably the optimum. In the present series the maximum numbers of complications were in those cases that had surgery within 2 weeks to 6 months after completion of RT.…”

Section: Discussionmentioning

confidence: 99%

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A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

Dasgupta

Sen

et al. 2016

Int J Res Med Sci

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INTRODUCTIONModern multimodal treatment for cancer which comprise principally of surgery with radiation and chemotherapy has improved the prospect of quality and quantity of life for the unfortunate patients suffering from head and neck cancer. The combined use of radiation and surgery has been practiced for a considerable time period and of late ABSTRACT Background: Radiation therapy is an established modality in the treatment of head and neck cancer patients. It is used alone or in combination with surgery and chemotherapy. Although radiotherapy is useful to affect tumour death, it also exerts a deleterious effect on surrounding normal tissues. These effects are either acute or can manifest months or years after the treatment. The chronic wounds are a result of impaired wound healing. Compromised wound healing in irradiated tissues is a common and challenging clinical problem. Methods: A prospective observational study was done in a tertiary care teaching institute, Kolkata. The effect of radiation on surgery of cancers of head and neck was studied in 50 patients. The patients were divided into 2 groups of 25 each. The cases in the first group were irradiated prior to surgery and those on the second group were operated upon without any pre-radiation. Results: The highest incidence of wound complications in those patients who were operated upon within 2 weeks to 6 months of completion of RT (83.33%). Patients who had their blood Hb level at or above 11 gm% developed less number of wound complications (34.78%) as compared to those who had their blood Hb level between 8-11 gm% where complication rate was 48.15%. Those patients who had their oral cavity or pharynx opened during surgery had a much higher incidence of wound complications (54.54%) than whose oral cavity or pharynx were not interfered with (17.64%). Wound infection was 36% in the irradiated group and 12% in the non-irradiated group. Separation of wound edges or skin necrosis followed in 28% cases in the pre-radiated group and in 8% cases in the non-pre-radiated group. Conclusions: Radiotherapy is an integral modality of head and neck cancer therapy. Compromised wound healing is an important side effect of radiation therapy. All sorts of local complications as wound infection and necrosis, or ocutaneous fistulae, carotid artery perforation etc. are more pronounced in patients, who received prior radiotherapy. The complication of surgery after radiotherapy was found to be more pronounced between 2 weeks to 6 months in this series.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

Dasgupta

Sen

et al. 2016

Int J Res Med Sci

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“…Many clinicians have established that integrated therapy can be done without incurring an additional penalty to the patient (Henschke et al, 1966;Silverstone and Goldman, 1963;Stearns et al, 1961). An unanswered question is how much is gained by the use of this technique in terms of increased survival.…”

Section: Discussionmentioning

confidence: 99%

Integrated radiation and operation in the treatment of carcinoma of the head and neck: Experience in 101 patients

Rush

Mooney

Jewell

et al. 1971

Journal of Surgical Oncology

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We have reviewed the results of treatment in 101 patients with combined radiationoperation therapy for lesions of the head and neck. We conclude that combined therapy does not significantly increase morbidity and mortality of treatment as long as certain features in the technique of radiation and operation are observed. Actuarial analysis of the 3-year survivals was done. Preliminary conclusions are that there is an improvement in survival, especially in those patients with positive cervical nodes.

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Role of radiation therapy in the treatment of supraglottic carcinoma

Deffebach

Phillips

1972

Cancer

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One hundred and one cases of early and late supraglottic tumors covering a period of 22 years have been evaluated. The early stages, without lymph node metastasis, show a 75% 2‐year control and a 50% 5‐year survival. The local control rate is 75% in those patients treated at a dose equivalent to more than 1700 rets. More advanced supraglottic tumors with lymph node metastasis have shown a 15% 2‐year control rate, 10% 5‐year survival when treated with irradiation alone. We are now treating the more advanced tumors with clinical adenopathy with a course of preoperative irradiation of 4000 to 5500 rads in 5 to 6 1/2 weeks followed at an appropriate interval in all cases with radical surgical removal of the primary and draining node areas. Conservation surgery is being considered in the advanced cases as an alternative to total laryngectomy. Lesions without clinical nodes in the supraglottic area should be treated by radiation therapy alone. At least 6000 rads in 6 1/2 weeks should be delivered to the primary and node‐draining areas. Conservation surgery in these earlier cases can be reserved for radiation treatment failures, thus sparing the voice in 75% or more of the cured patients.

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Combined High Dose Radiation Therapy and Surgery of Advanced Cancer of the Laryngopharynx

Cited by 4 publications

References 0 publications

A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

Integrated radiation and operation in the treatment of carcinoma of the head and neck: Experience in 101 patients

Role of radiation therapy in the treatment of supraglottic carcinoma

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