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J Korean Soc Ther Radiol > Volume 9(1); 1991 > Article
Journal of the Korean Society for Therapeutic Radiology 1991;9(1): 73-80.
Treatment Result in Advanced T3 and T4 Glottic Carcinoma: YUMC Experience
Hyun Soo Shin, Hyung Sik Lee, Eun Ji Chung, Gwi Eon Kim, Juhn Kyu Loh, Chang Ok Suh, Kwang Moon Kim, Won Pyo Hong
1Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
2Department of Otolarynglogy, Yonsei University College of Medicine, Seoul, Korea.
Between January 1980 and September 1988, 68 patients with advanced T3 & T4 glottic carcinoma were treated with RT and surgery/RT in the Department of Radiation Oncology, Yonsei Cancer Center and ENT, Yonsei University College of Medicine. The mean age was 60 years old (range 33 to 79 year old). The 34 patients were treated with irradiation alone, and the remaining 34 patients with surgery and irradiation. Initial nodal presentation was 37% (25/68); 31% (11/34) in RT alone group and 41% (14/34) in combined treatment group. The minimum follow-up was 2 years. The local control rate after treatment was 47% in RT alone group and 65% in combined treatment group; 57% for node negative and 27% for node positive patients treated with RT alone; 65% for node negative and 64% for node positive patients treated with combined treatment. The treatment failure was observed in 30 patients; 14 patients for primary local failure, 6 patients for regional nodal failure, 6 patients for local and regional failure, 26 patients for primary failure and/or distant metastasis, and 2 patient for regional failure and/or distant metasasis. The overall 5-year survival rate was 57%; 37% in RT alone group and 76% in combined treatment group; 55% for node negative and 20% for node positive patients treated with RT alone; 73% for node negative and 77% for node positive patients treated with combined treatment. In conclusion, the combined treatment groups in the treatment of advanced T3 and T4 glottic cancer showed the better results in local control rates and 5-year actuarial survival rates than RT alone group. We suggest that total laryngectomy and postoperative RT in the most patients of advanced glottic cancer were performed. However, in cases of node negative patients, RT alone is prefer as a treatment modality over combined surgery and RT since the treatment results were comparable and furthermore functional preservation could be achieved.
Key Words: Advanced glottic cancer, Radiation therapy
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