Conservative thermochemoradiation therapy of locally advanced laryngeal cancer

Abstract

Thermochemoradiation therapy was performed in 31 patients with laryngeal cancer (T3-4N0-3M0). Radiotherapy was performed in 2 stages 1+1 Gy (every 4-5 hours), 5 times a week to SOD 52-60 Gy with a 2-week break after SOD 3032 Gy. Local hyperthermia was carried out two times a week before the second fraction in an amount of radiation therapy sessions 3-6. In the days of local hyperthermia second fraction of radiotherapy increased to 3 Gy. Courses of chemotherapy were combined with radiation therapy and local hyperthermia at the beginning of each stage of treatment. For the whole group a complete response of the primary tumor was diagnosed in 25 (80.6 %) patients, partial — in 6 (19.3 %). Of the 12 patients with N1-3 complete regression of metastases occurred in 5 (41.7 %), partial — also in 5 (41.7 %). Five-year overall survival was 88.2 % T3N0, T4N1 in 3 — 62.1 %. Local control of the primary tumor in these terms in the group T3 was detected in 88.2 %, in the group T4 — 77.8 %, regional control of metastases with N1-3 — 33.3 %. Late swelling of the mucous membrane of the larynx developed in 4 (12.9 %) patients, perichondritis — in 3 (9.7 %). Thermochemoradiation therapy of locally advanced cancer of the larynx provides a fairly good results comparable with those of the combined treatment.