[Comparative assessment of the five-year results of surgical, combined, radiation and chemoradiotherapy in laryngeal cancer (T3N0M0)].

Four modalities of specific treatment for laryngeal cancer were compared in 158 patients. Five-year survival after chemoradiotherapy using cisplatin, 5-FU and bleomycin plus irradiation (65-70 Gy) was 87% versus 69.7; 66.2 and 45.9% after surgical, combined and radiotherapy, respectively. Chemoradiotherapy failed in 22.4%, as compared with 28.9; 31.5 and 41.7% after the alternative modalities, respectively. Organ preservation was used in 30.3% of surgical cases and 58%--in combined treatment group.

[Autofluorescence diagnosis of malignant tumors of the head and neck]. / Autofliuorestsentnaia diagnostika zlokachestvennykh opukholei golovy i shei.

A new method for diagnosing human malignant tumors is dealt with, which is based on fluorescence of malignant neoplasms and their adjacent normal tissue. To measure the fluorescence spectra, a fiber optic system and a multi-channel optic spectral analyser have been designed. While analysing the resultant spectra, a greater fluorescence excess was observed in the red wave band in the tumors than in normal tissue. Further investigations are required in order to use the method in question in clinical diagnosis.

[Combined treatment of stage III laryngeal cancer with different schedules of radiotherapy and surgery. Evaluation of preventive methods of the treatment of regional areas (cooperative randomized study)]. / Kombinirovannoe lechenie raka gortani III stadii s razlichnoi posledovatel'nost'iu oblucheniia i operatsii. Otsenka preventivnykh metodov vozdeistviia na regionarnye zony (po materialam kooperirovannogo randimizirovannogo issledovaniia).

In 1980-1987, a cooperative randomized study of 363 patients with stage III laryngeal cancer (T1-3N0-1M0) was carried out. In 249 patients tumor was located in the vestibular space and in 114 in the vocal cord area; 78.5% of the patients had no regional metastases (N0) and 21.5% had metastases (N1). Combined therapy was applied to 251 patients, 135 of which were first exposed to radiotherapy and then to surgery and 116 were first exposed to surgery and then radiotherapy. In 71 patients, regional zones underwent preventive treatment (in 24 patients elective radiotherapy and in 47 preventive removal of the cervical fat were used). In 112 patients, the therapeutic protocol was modified due to different reasons (69 patients underwent only surgery and 43 radical radiotherapy). The therapeutic results were assessed in terms of three parameters: incidence of relapses and regional metastases, relapse-free time, and survival. This approach revealed no significant differences in the efficacy of the different protocols of the combined treatment. The 5-year survival rate of the patients with vestibular and cord space tumor was 77.9% and 80.7% respectively, when treated according to the radiotherapy + surgery protocol, and 82.8% and 89.2%, respectively, when treated according to the surgery + radiotherapy protocol. Comparison of preventive approaches showed that the 5-year survival rate increased by 92% as a result of removal of the subcutaneous fat from the neck area.

[Comparative evaluation of the effectiveness of radiotherapy, surgery and combined treatment of stage I-II laryngeal cancer (T1-2NoMo) based on the data of a cooperative randomized study]. / Sravnitel'naia otsenka éffektivnosti luchevogo, khirurgicheskogo i kompleksnogo lecheniia raka gortani I-II stadii (T1-2NoMo) po materialam kooperirovannogo randomizirovannogo issledovaniia.

During 1979-1987 269 patients with laryngeal cancer stage I-II were included into a cooperative randomized study: 111 patients had T1 and 158 patients, T2 tumor; 13% of patients showed cancer of the vestibular cord and 87% of them of the true vocal cord. 76 patients underwent surgery, 129 patients--radiotherapy, and 64 patients received combined treatment, i.e. radio- and chemotherapy (prospidine). The rate of relapses and regional metastases was 11.8 +/- 3.7% and 2.6 +/- 1.8% after surgery, 21.4 +/- 3.8% and 1.6 +/- 1.1% after radiotherapy, and 23.4 +/- 5.3% and 6.3 +/- 3.0% after combined treatment. In terms of the recurrence-free time surgical intervention showed the highest efficacy. With respect to the 5-year survival, measured in the above patients plus 42 patients operated on because of relapses and regional metastases, surgery of vocal cord cancer was effective in 100% in case of stage I, 97.4% in case of stage II; radiotherapy was effective in 91.7% in case of stage I, 88.8% in case of stage II, and combined treatment was effective in 100% in case of stage I and 70.3% in case of stage II; surgery of vestibular cord cancer stage II was effective in 100%, combined treatment in 88.9%, and radiotherapy in 68.6%. When vocal cord cancer involves the anterior commissure, ventricle, and space, preference should be given to surgery because relapses after radiotherapy were seen in 38-42%. Combined radio- and chemotherapy did not reduce the recurrence rate and therefore cannot be recommended for practical purposes.

[Carcinoid of the larynx]. / Kartsinoid gortani.

Laryngeal carcinoid with metastases to cervical lymph nodes was observed in a patient of 62. The diagnosis was confirmed by electron-microscopic study. The patient was followed up for 9 mos without any evidence of recurrence and metastases after laryngectomy and fascial envelope excision of cervical fat. The morphologic picture of laryngeal carcinoid is characterized by the presence of the alveolar, trabecular and teniform structures consisting of monomorphic and moderately polymorphic cells. Tubular and rosette-like structures occur. The overlying epithelium is intact. The necrotic foci, as a rule, are absent. Grimelius reaction is positive, argentaffinnic granularity isn't revealed. Electron-microscopic study demonstrates endocrine-type granules. The need for recognition of laryngeal carcinoid is explained by the fact that this tumour form has a more favourable course and prognosis in comparison to cancer.