Salvage treatment of primary recurrence in patients with laryngeal cancer after definitive radiotherapy / 中国癌症杂志

ABSTRACT

Purpose:To investigate the clinical applicati on and curative effect of salvage treatment for primary recurrence after definitiv e radiotherapy in patients with laryngeal cancer. Methods:52 patients with laryngeal cancer receiving definitive radiotherapy in the Cancer Center of Sun Yat-sen University between 1990 and 19 95 were reviewed retrospectively. Among them, 17 patients presented with primary recurrence. Salvage treatment after radiotherapy failure included palliative ch emotherapy (5 cases) and surgical salvage (12 cases). 6 patients were salvaged b y partial laryngectomy and 6 patients by total laryngectomy. SPSS 10.0 software was used to analyze the effects, complications and the differences between diffe rent salvage treatments. Results:The overall 3- and 5-year cumulative survival rates a fter salvage treatment for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy were 56.3% and 37.5% respectively. The patient s receiving palliative chemotherapy after radiotherapy failure survived between 8 and 26 months. The 3- and 5-year cumulative survival rate in patients receiv ing surgical salvage were 75% and 50% respectively. There was significant differ ence between them analyzed by Kaplan-Meier (Log Rank=8.14, P=0.004 3). More over, the 5-year survival rates in patients salvaged by partial laryngectomy an d total laryngectomy were all 50% and there was no statistical difference betwee n them (Log Rank=0.08, P=0.7782). 5 out of 12 (41.7%) patients salvaged by s urgery presented complication after surgery, mainly infection after surgery (25 %) and pharyngocutaneous fistula (25%). Conclusions:Surgical salvage for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy could be effective.Part ial laryngectomy could be used for early primary lesion (T 1 and T 2) in patie nts with primary recurrence. The complications after salvage surgery were mainly were infection and pharyngocutaneous fistula.