The Feasibility of Selective High-Risk Area Irradiation for Supraglottic Laryngeal Carcinoma With Positive Lymph Nodes Only in Areas II and IIIThe Feasibility of Selective High-Risk Area Irradiation for Supraglottic Laryngeal Carcinoma With Positive Lymph Nodes Only in Areas II and III
Abstract ObjectiveTo study the prognosis of patients with positive lymph nodes in area II and III after supraglottic laryngocarcinoma surgery and to evaluate the feasibility of selective irradiation of a high-risk area. MethodsFrom February 2010 to March 2015, the complete clinical data for 181 patients treated for supraglottic laryngeal cancer at the Radiotherapy Department of the Second Hospital of Jilin University were analysed retrospectively. Among them, 100 patients were treated with whole neck prophylactic irradiation and 81 patients were treated with selective high-risk irradiation; i.e., lymph drainage of areas II and III. ResultsThe median follow-up time was 38.5 months; the 5-year OS, PFS, and NFS were 67.9%,58.1%,64.6% respectively. Among them, there were 6 cases of lymph node recurrence, 4 cases of local recurrence, 8 cases of distant metastasis and 58 deaths. However, there was no significant difference in recurrence between the selective high-risk radiation group and the total neck prophylactic radiation group. The OS, PFS and NFS of the two groups were 67.9% vs. 68%, 58.02% and 58%, and 62.9% and 66%, respectively, and the P values were 0.9161, 0.8916 and 0.7333,respectively. For late toxicity resulting from radiotherapy, the incidence of cervical fibrosis (2.47% vs. 10%, P = 0.043) and the incidence of throat mucosa injury (6.17% vs. 24%, P = 0.001) in patients in the selective high-risk area irradiation group were reduced. ConclusionThe preliminary data show that selective high-risk area irradiation is safe and feasible for patients with supraglottic laryngeal cancer accompanied by positive lymph nodes only in areas II and III, and the treatment can reduce the long-term adverse reactions and improve the quality of life. However, more evidence is needed.