Efficacy and Morbidity of Partial Laryngectomy and Postoperative Radiation Therapy

This retrospective study, based on a series of 90 patients with invasive squamous cell carcinoma of the supraglottis, was designed to document the functional outcome and complications after postoperative radiation therapy following partial laryngeal surgery. The surgical procedure was a standard supraglottic laryngectomy in 62 patients and a supracricoid partial laryngectomy in 28 patients. All of the patients had an unremarkable postoperative course and achieved locoregional control. The average dose delivered to the remaining larynx was 51.2 Gy (range 25-71 Gy). The average dose delivered to the neck was 50.6 Gy (range 2270 Gy). The patients were treated at 180-cGy per fractions in a continuous course technique with a cobalt 60 beam. In 5 patients (5.5%) complications led to cessation of postoperative radiation therapy, and the total dose delivered to the remaining larynx and neck was less than 40 Gy. All patients were followed up for a minimum of 10 years or until death. The 5-, 10-, and 15-year actuarial survival estimates were 71.5%, 44.3%, and 36.3%, respectively. The 5-, 10-, and 15-year actuarial severe complication estimates were all 11.2%. Overall, severe complications occurred in 15 patients. Severe complications led to death in 3 patients (3.3%), permanent gastrostomy in 3 (3.3%), and permanent tracheostomy in 1 (1.1%). A severe complication never resulted in completion of total laryngectomy. In univariate analysis, the mean dose delivered to the larynx was the only variable statistically related to the incidence of a severe complication. The mean dose delivered to the larynx was statistically higher ( P = 0.014) in patients who had severe complications (60 Gy) than in patients who did not (50 Gy).

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Complications of Postoperative Radiation Therapy after Partial Laryngectomy in Supraglottic Cancer: A Long-Term Evaluation

Otolaryngology ◽

10.1016/s0194-5998(00)70210-5 ◽

2000 ◽

Vol 122 (5) ◽

pp. 752-757 ◽

Cited By ~ 19

Author(s):

Ollivier Laccourreye ◽

Stéphane Hans ◽

Ali Borzog-Grayeli ◽

Catherine Maulard-Durdux ◽

Daniel Brasnu ◽

...

Keyword(s):

Radiation Therapy ◽

Univariate Analysis ◽

Severe Complication ◽

Partial Laryngectomy ◽

Invasive Squamous Cell Carcinoma ◽

Average Dose ◽

Postoperative Radiation ◽

Actuarial Survival ◽

Postoperative Radiation Therapy ◽

The Mean

This retrospective study, based on a series of 90 patients with invasive squamous cell carcinoma of the supraglottis, was designed to document the functional outcome and complications after postoperative radiation therapy following partial laryngeal surgery. The surgical procedure was a standard supraglottic laryngectomy in 62 patients and a supracricoid partial laryngectomy in 28 patients. All of the patients had an unremarkable postoperative course and achieved locoregional control. The average dose delivered to the remaining larynx was 51.2 Gy (range 25–71 Gy). The average dose delivered to the neck was 50.6 Gy (range 2270 Gy). The patients were treated at 180-cGy per fractions in a continuous course technique with a cobalt 60 beam. In 5 patients (5.5%) complications led to cessation of postoperative radiation therapy, and the total dose delivered to the remaining larynx and neck was less than 40 Gy. All patients were followed up for a minimum of 10 years or until death. The 5-, 10-, and 15-year actuarial survival estimates were 71.5%, 44.3%, and 36.3%, respectively. The 5-, 10-, and 15-year actuarial severe complication estimates were all 11.2%. Overall, severe complications occurred in 15 patients. Severe complications led to death in 3 patients (3.3%), permanent gastrostomy in 3 (3.3%), and permanent tracheostomy in 1 (1.1%). A severe complication never resulted in completion of total laryngectomy. In univariate analysis, the mean dose delivered to the larynx was the only variable statistically related to the incidence of a severe complication. The mean dose delivered to the larynx was statistically higher (P = 0.014) in patients who had severe complications (60 Gy) than in patients who did not (50 Gy).

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Immediate Postoperative Radiation Therapy after Free Tissue Transfer for Keloid Treatment

The Laryngoscope ◽

10.1002/lary.29344 ◽

2021 ◽

Author(s):

Jacqueline A. Wulu ◽

Scott W. Finlay ◽

Minh‐Tam Truong ◽

Waleed H. Ezzat

Keyword(s):

Radiation Therapy ◽

Free Tissue Transfer ◽

Postoperative Radiation ◽

Postoperative Radiation Therapy ◽

Tissue Transfer

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Functional and psychosocial effects of multimodality limb-sparing therapy in patients with soft tissue sarcomas.

Journal of Clinical Oncology ◽

10.1200/jco.1989.7.9.1217 ◽

1989 ◽

Vol 7 (9) ◽

pp. 1217-1228 ◽

Cited By ~ 28

Author(s):

A E Chang ◽

S M Steinberg ◽

M Culnane ◽

M H Lampert ◽

A J Reggia ◽

...

Keyword(s):

Radiation Therapy ◽

Soft Tissue ◽

Sexual Activity ◽

Standardized Test ◽

Soft Tissue Sarcomas ◽

High Grade ◽

Postoperative Radiation ◽

Limb Function ◽

Postoperative Radiation Therapy ◽

Global Quality Of Life

We have documented functional and psychosocial changes in patients with extremity soft tissue sarcomas who have undergone multimodality limb-sparing treatments. In 88 patients, parameters related to economic status, sexual activity, pain, limb function, and global quality of life (QOL) were recorded prior to surgery and every 6 months postoperatively. Changes from the preoperative assessment for every parameter were analyzed in each patient. Six months after surgery, there was a decrease in employment status, sexual activity, and in limb function in a significant number of patients. At 12 months, these decreases were still evident. Despite these changes, global QOL measured by a standardized test showed at least some improvement in a significant proportion of patients at 12 months. These findings highlight the difficulty in defining QOL. It could not be ascertained if radiation therapy and/or chemotherapy were causative factors in specific changes because of the small numbers of patients in each subgroup. However, among 60 patients with high-grade sarcomas, significant wound problems developed in 10 of 33 who received postoperative radiation therapy in combination with adjuvant doxorubicin and cyclophosphamide chemotherapy compared with one of 27 patients who received adjuvant chemotherapy alone (P = .016). Also, among high-grade sarcoma patients with 12-month follow-up, six of 19 patients who received radiation therapy and chemotherapy developed joint contractures compared with zero of 15 patients who received chemotherapy alone (P less than .04). The combination of postoperative radiation therapy and chemotherapy appeared to be associated with significantly more tissue-related injury in patients with high-grade sarcomas compared with chemotherapy alone.

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