Failures after irradiation in early vocal cord cancer

Abstract

Radiation therapy for early laryngeal cancer offers an excellent probability of cure as well as preservation of vocal function. Reported failure rates range from 9 to 21% in patients with T1 lesions, and from 28 to 44% in those with T2 lesions, the majority of whom are subsequently salvaged by surgery. Results obtained at the Radiotherapy Center of the University of Wisconsin Hospitals in 44 patients during the period from 1960 to 1972 yielded failure rates of 21% in patients with T1 tumors and 38% in patients with T2 tumors at 5 years. Five of the eight recurrences were salvaged with surgery yielding an overall tumor control rate of 93%. The larynx was preserved in 82% of the cases. Determinate 5-year survival was 91% in T1 cases and 86% in T2 cases. Failure rates at 3 years were 18% for T1 tumors and 30% for T2 lesions. These results are in conflict with those reported by Brandenburg and Rutter as being 46% and 60% respectively. Ultimate success in the treatment of laryngeal cancer rests in the full cooperation between surgeons and radiotherapists.

Endoscopic laser surgery in the treatment of radiation failure of early laryngeal carcinoma

“…Although total laryngectomy is required in most patients with recurrent carcinoma, 7-10 in selected cases, conservation surgery with preservation of a portion of the larynx is feasible. [11][12][13][14] Partial laryngectomy in selected patients with T1 and T2 radiation-failure laryngeal carcinoma is reported to be successful in 60% to 81% of patients. [10][11][12][13][14][23][24][25][26][27] There are few reports about the use of endoscopic laser surgery in postradiation failure.…”

“…Unfortunately, in many instances, the recurrent tumor extends beyond its original site, and total laryngectomy is necessary. [13][14][15][16] However, in carefully selected cases, conservation surgery with preservation of a portion of the larynx is feasible. [17][18][19][20] Endoscopic laser surgery was recently proposed when conservation surgery is possible in cases of radiation-failure.…”

Voice after laryngectomy.

“…5 The main problem is more long term and is simply the failure of the components to remain fixed to bone owing to fractured cement,6 loss of bone stock,7 and the wear products produced by the friction between the metal femoral component and the high density polyethylene acetabulum. 8 Because most hip replacements will fail given time the right patient must be chosen for the operation in the first place. Those over 60 years old are likely to place less strain on the hip and thus improve its lifespan.9 Younger patients and those who are overweight do not do so well.…”

A brief review of voice restoration following total laryngectomy

“…[1] However, for those who do not respond or present with recurrent or advanced disease, total laryngectomy is the only curative approach that can be offered. [2] The prognosis of laryngectomized patients has remained relatively favorable over the years, with five-year survival rates of 65 -75%. [3] However, the procedure has various functional and physiological consequences.…”