Carcinoma of the supraglottic larynx: treatment results with radiotherapy alone or with planned neck dissection

Extensive resection of carcinoma that involves the tongue base and supraglottic larynx is accompanied by significant potential morbidity and mortality. This is often indicated by poor rates of cure and the limited palliation afforded by radiotherapy alone. Removal of a significant portion of the posterior tongue frequently results in intractable aspiration. Techniques in reconstruction of the oropharyngeal defect and tongue base have included primary closure, random flaps, and myocutaneous flaps. Each of these techniques has been successful, to some degree, in resurfacing pharyngeal defects. However, the functional results in regard to deglutition are less than satisfactory as a result of aspiration. Frequently, simultaneous or delayed total laryngectomy is performed to deal with the pulmonary complications. Various types of laryngoplasty do not uniformly correct the problems of aspiration and deglutition associated with subtotal glossectomy. Our experience includes eight patients who had advanced squamous cell carcinoma of the tongue base, vallecula, and the supraglottic larynx. All patients underwent partial or subtotal glossectomy and laryngectomy. The mucosal defect was reconstructed with pectoralis myocutaneous flap. In order to reestablish voice, a primary tracheopharyngeal shunt was created with the use of a portion of cricoid and upper trachea. The majority of these patients have had successful rehabilitation of deglutition, mastication, and speech.

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Radiotherapy alone or combined with neck dissection for T1−T2 carcinoma of the pyriform sinus: An alternative to conservation surgery

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(93)90518-z ◽

1993 ◽

Vol 27 (5) ◽

pp. 1017-1027 ◽

Cited By ~ 46

Author(s):

William M. Mendenhall ◽

James T. Parsons ◽

Scott P. Stringer ◽

Nicholas J. Cassisi ◽

Rodney R. Million

Keyword(s):

Neck Dissection ◽

Pyriform Sinus ◽

Conservation Surgery ◽

Radiotherapy Alone

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Adjuvant intravenous methotrexate or definitive radiotherapy alone for advanced squamous cancers of the oral cavity, oropharynx, supraglottic larynx or hypopharynx

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(80)90379-x ◽

1980 ◽

Vol 6 (5) ◽

pp. 533-541 ◽

Cited By ~ 91

Author(s):

John T. Fazekas ◽

Charles Sommer ◽

Simon Kramer

Keyword(s):

Oral Cavity ◽

Definitive Radiotherapy ◽

Radiotherapy Alone ◽

Supraglottic Larynx

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Transoral robotic surgery and neck dissection as primary treatment results in reduced adjuvant treatment for patients with advanced oropharyngeal squamous cell cancer

10.26226/morressier.5adde3c2d462b80290b59444 ◽

2018 ◽

Author(s):

Harry Tustin

Keyword(s):

Robotic Surgery ◽

Neck Dissection ◽

Squamous Cell ◽

Adjuvant Treatment ◽

Squamous Cell Cancer ◽

Cell Cancer ◽

Primary Treatment ◽

Transoral Robotic Surgery ◽

Treatment Results

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Non-Hodgkin's Lymphomas of Waldeyer's Ring

Tumori Journal ◽

10.1177/030089168306900208 ◽

1983 ◽

Vol 69 (2) ◽

pp. 129-136 ◽

Cited By ~ 16

Author(s):

Emilio Bajetta ◽

Roberto Buzzoni ◽

Franco Rilke ◽

Pinuccia Valagussa ◽

Rosella Rovej ◽

...

Keyword(s):

Treatment Results ◽

Histologic Diagnosis ◽

Waldeyer’S Ring ◽

Pathologic Staging ◽

Radiotherapy Alone ◽

Frequent Site ◽

Hodgkin's Lymphomas ◽

Rappaport Classification ◽

Patterns Of Recurrence ◽

Working Formulation

From 1970 to 1980, 171 consecutive cases with non-Hodgkin's lymphomas (NHL) of Waldeyer's ring were admitted to this Institute. The cases were reviewed to evaluate whether involvement of Waldeyer's ring might represent a distinct clinicopathologic entity. Adequate pathologic staging was performed in 86% of cases. All slides were reviewed, and the histologic diagnosis given according to the Rappaport classification, the Kiel classification, and the recent Working Formulation of NHL for Clinical Usage. Waldeyer's ring alone was involved in 12.3% of the cases at presentation; regional nodes were positive in one-third (35.7%), and distant involvement was detected in half of the patients (52%). The tonsils represented the most frequent site of involvement by NHL within Waldeyer's ring. Treatments employed were heterogeneous, but most of the patients with stage I-II received radiotherapy alone. The present series shows that the association of involvement of Waldeyer's ring and the stomach by NHL occurs in less than 10% of the cases. Treatment results and patterns of recurrence fail to differentiate NHL involving Waldeyer's ring from those of other sites. Prognosis remains related to the classical variables and is independent of the site of onset.

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An Evaluation of Elective Irradiation of Neck Nodes in Patients with Cancer of the Supraglottic Larynx

Tumori Journal ◽

10.1177/030089168106700209 ◽

1981 ◽

Vol 67 (2) ◽

pp. 129-133 ◽

Cited By ~ 1

Author(s):

Jan Skolyszewski

Keyword(s):

Neck Dissection ◽

Metastatic Cancer ◽

Randomized Study ◽

Survival Rates ◽

Treatment Groups ◽

Patients With Cancer ◽

Supraglottic Cancer ◽

Supraglottic Larynx ◽

Megavoltage Therapy

Between 1964 and 1973, 152 patients with supraglottic cancer limited to the larynx with clinically negative neck were included in the controlled randomized study designed to evaluate elective irradiation of the neck. The patients were randomized to one of the 2 treatment groups: 1) « T + N »: irradiation of the larynx and all neck nodes, tumor dose 5130 rad/6-7 weeks, 2) « T »: irradiation of the laryngeal portals only, tumor dose 5130 rad/5 weeks. All patients received 250 kV orthovoltage irradiation. The biologic dose delivered to the larynx was greater in group « T » because of faster fractionation and shorter overall time of therapy. The calculated NSD value for the patients in group « T + N » varied from 1620 to 1690 ret, and in group « T » it was 1800 ret. Five-year survival rates with a preserved larynx and without cancer were 45.3 % for group « T + N » and 66.2 % for group « T ». Seven patients of group « T » developed metastatic cancer in the neck, and 4 of them were cured by neck dissection. It is concluded that patients with early supraglottic cancer can be successfully irradiated through laryngeal portals only, including the larynx, and possibly midjugular and digastric nodes. The tumor dose should be at least equivalent to the NSD of 1800 ret in the condition of megavoltage therapy.

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Radiotherapy Alone or With Chemotherapy in the Management of Carcinoma of the Supraglottic Larynx

American Journal of Clinical Oncology ◽

10.1097/coc.0000000000000398 ◽

2018 ◽

Vol 41 (9) ◽

pp. 894-897

Author(s):

Amy R. Rao ◽

Daniel A. Jones ◽

Charles M. Mendenhall ◽

Syed N. Rizvi ◽

Jessica Kirwan ◽

...

Keyword(s):

Radiotherapy Alone ◽

Supraglottic Larynx

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Present radiochemotherapic approaches for advanced cervical cancer. Options for reduction of side-effects

Orvosi Hetilap ◽

10.1556/oh.2013.29618 ◽

2013 ◽

Vol 154 (21) ◽

pp. 803-809

Author(s):

Zsuzsa Póti ◽

Árpád Mayer

Keyword(s):

Cervical Cancer ◽

Side Effects ◽

Survival Rates ◽

Previous Treatment ◽

Combined Treatments ◽

Treatment Results ◽

Advanced Stages ◽

Radiotherapy Alone ◽

Overall Survival Rates ◽

Better Than

The advantages of cisplatin based radiochemotherapy have been proven for over one and a half decades, particularly in the treatment of advanced solid tumours. In head and neck, and cervical tumours results of prospective studies are available. Those showedthat both in the early and advanced stages, local control and overall survival rates are better than radiotherapy alone. The effect of cisplatin can be probably intensified with novel, more effective molecules, such as m-TOR inhibitors and tirapazamine. The authors review cisplatin and non-cisplatin based radiochemotherapy protocols, which improve previous treatment results. It should be considered, however, radiotherapy for cervical cancer can cause hematological, urogenital and intestinal toxicity, similarly to other combined treatments. The authors briefly outline international recommendations and their own experience for the prevention of these side-effects. Orv. Hetil., 2013, 154, 803–809.

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