Carcinoma do Laringe: Análise dos resultados de 57 pacientes, estádios III e IV, tratados com cirurgia e radioterapia radicais
DOI:
https://doi.org/10.32635/2176-9745.RBC.1987v33n1.3162Keywords:
Laryngeal Neoplasms, General Surgery, Radiotherapy, PrognosisAbstract
From January 1981 to December 1983, 51 patients referred to the Instituto Nacional de Câncer with advanced carcinoma of the larynx were treated by radical surgery and radiotherapy. The supraglottic region was the most commonly affected. Local control was 79% and the actuarial survival rate was 55%. Ten patients (17,5%) developed distant disease. The prognostic significance of stage T nodal involvement, resection margins and elapsed time between surgery and radiotherapy was evaluated. None of these factors influenced the local control rate. However, N2 tumors did have a worse survivalrateascomparedtoN0 tumors (36%) vs76%; p = 0,02). These findings suggest that the initial surgical approach should be more conservative and that radical neck dis-section does not seem to improve local control or to reduce mortality rate.
Downloads
References
Brumini R — Câncer no Brasil. Dados histológicos 1976T980. Campanha Nacional de Combate ao Câncer. Ministério da Saúde. 1982.
Ogura JH, Sessions DG, Spector GJ - Analysis of surgical therapy for epidermoid carcinoma of lhe laryngeal glottis. Laryngoscope, 1975; 85: 1522-1530. DOI: https://doi.org/10.1288/00005537-197509000-00015
Fletcher GH, Klein R - Dose-time-volume relationship In squamous cell carcinoma of lhe larynx. Radiology, 1964, 82: 1032-1041. DOI: https://doi.org/10.1148/82.6.1032
Mendenhall WM, Millon RR, Sharkey DE, Cassisi NJ - Stage T3 squamous cell carcinoma of lhe glottic larynx treated with surgery and/or radiation therapy. Int J Radial Oncol Biol Phys, 1984; 10: 357-363. DOI: https://doi.org/10.1016/0360-3016(84)90054-3
Harwood AR - Management of laryngeal carcinoma. Rev Bras Cancerol, 1985: 31: 161-168. DOI: https://doi.org/10.32635/2176-9745.RBC.1985v31n2.3330
International Union Against Cancer — TNM Classification of Malignant Tumors. Geneva, 1979.
Kaplan EL, Meier P - Non parametric estimation for incomplete observations. J Am Slat Assoe, 1985; 53: 457-481. DOI: https://doi.org/10.1080/01621459.1958.10501452
Sagerman RH, Chung CT, King GA, Yu WS, Cummings CW, Johnson JT - High dose preoperative irradialion for advanoed laryngeal-hypopharyngeal cancer. Ann Otol, 1979; 88: 178-182. DOI: https://doi.org/10.1177/000348947908800205
Harwood AR, Hawkins NV, Beale FA, Rider WD, Bryee DP — Management of advanced glottic cancer: A 10- year review of lhe Toronto experience. Int J Radial Onool Biol Phys, 1979; 5: 473-476. DOI: https://doi.org/10.1016/0360-3016(79)90075-0
De Santo LW – T3 glottic cancer. Options and consequences of the options. Laryngoscope, 1984; 94: 1311-1315. DOI: https://doi.org/10.1288/00005537-198410000-00010
Bogaert W V, Ostyn F, Der Schueren EV - The primary treatment of advanced vocal cord cancer: laryngectomy or radíotherapy? Int J Radial Oncol Biol Phys, 1983; 9: 329-334. DOI: https://doi.org/10.1016/0360-3016(83)90291-2
KirchnerJA — One hundred laryngeal cancersstudied by serial section, Ann Otolaryngol Rhinol Laryngol, 1969; 78: 689-709. DOI: https://doi.org/10.1177/000348946907800402
Pera E, Moreno A, Galindo L - Prognostic factors in laryngeal carcinoma. A multifactorial study of 416 cases. Cancer, 1986; 58: 928-934. DOI: https://doi.org/10.1002/1097-0142(19860815)58:4<928::AID-CNCR2820580421>3.0.CO;2-J
Desaulty A, Sancho Gernier H - Elude prospeclive des épilhéliomes du larynx: (Epel 1975-1981). Résultats d'une élude mullicentrique. Ann Olalaryngol (Paris), 1983; 100: 167-180.
Flelcher GH – Elective irradiation of subclinical disease in cancers of the head and neck. Cancer, 1972; 29: 1450-1454. DOI: https://doi.org/10.1002/1097-0142(197206)29:6<1450::AID-CNCR2820290605>3.0.CO;2-Q
Mendenhall WM, Miliion RR - Eleclive neck irradialion for squamous cell carcinoma of lhe head and neck: analysis of lime-dose faclors and causes of failures. inl J Radial Oncol Biol Phys, 1986; 12: 741-746. DOI: https://doi.org/10.1016/0360-3016(86)90031-3
Peters LP, Fleloher GH — Causes pf failure of radiolherapy in head and neck cancer. Radiol Oncol, 1983; 1: 53-63. DOI: https://doi.org/10.1016/S0167-8140(83)80007-3
Vikram B, Slrong EW, Shah J, Spiro RH - Eleclive posloperalive radiation therapy instages lll and IV epidermoid carcinoma of the head and neck. Am J Surg, 1980: 140: 580-584. DOI: https://doi.org/10.1016/0002-9610(80)90217-2
Harwood AR, Beale FA, Cummings BJ et al - Supragloltic laryngeal carcinoma: an analysis of dose-time-voiume faclors in 410 palienls. Int J Radial Oncol Biol Phys, 1983;9:311-319. DOI: https://doi.org/10.1016/0360-3016(83)90289-4
Stewart JG, Brown JR, Palmer MK, Cooper A - The management of glottic carcinoma by primary irradialion with surgery in reserve. Laryngoscopy, 1975; 85: 1477-1484. DOI: https://doi.org/10.1288/00005537-197509000-00008
Macieyewski B, Press-Bayer G, Trott KR — The influence of the number of fractions and of the overall treatment time on local control and late complications rate in squamous cell carcinoma of the larynx. Int J Radial Oncol Biol Phys, 1983; 9: 321-328. DOI: https://doi.org/10.1016/0360-3016(83)90290-0
