Advanced-stage (III and IV) laryngeal cancers have been classical treated by a combination of surgery and complementary radiotherapy. As surgery normally represents a mutilation in these cases (loses of laryngeal voice), some patients refuse it. Another group of patients presents such a deteriorated clinical condition that they shall not be submitted to a high-risk surgery. Chemotherapy and radiotherapy association has been less useful in our patients, which are frequently in bad clinical conditions and do not tolerate the therapeutical schemes high toxicity. In these cases, radiotherapy alone is the sole option we have to offer trying to control the disease. The authors retrospectively reviewed 62 advanced-stage (III an IV) laryngeal cancer patients treated by radiotherapy alone at Hospital do Câncer (Rio de Janeiro) during 1992 and 1993. The treatment had a curative intention in all cases with a classical dose of 50cGy in 5 weeks. We analyzed survival, disease stage, cervical metastasis, age, and the need for previous tracheotomy. Statistical analysis showed a 36 months stage III survival of 54% and 2/3 of them were kept without a tracheotomy tube, suggesting preservation of a functional larynx. This result had encouraged the authors to randomize studies for a better selection of patients who can mostly benefit from this therapeutic option.
Laringeal Cancer; Radiotherapy
