CONSERVATIVE THERMOCHEMORADIATION TREATMENT FOR LOCALLY ADVANCED LARYNGEAL CANCER

Abstract

Independent thermochemoradiation therapy was performed in 31 patients with laryngeal cancer (Т3–4N0–3M0). A radiotherapy (RT) regimen (1 + 1-Gy) was conducted in 2 steps (at 3–5-hour intervals) 5 times weekly up to a cumulative focal dose (CFD) of 50–52  Gy at a 2-week interval after a CFD of 30–32 Gy (Step 1). Local hyperthermia was carried out twice weekly before the second RT fraction in 3– 6 sessions. On the days of local hyperthermia, the second RT fraction was increased up to 3 Gy. Combination chemotherapy cycles were combined with RT at the start of each treatment step.

Complete and partial responses of a primary tumor were observed in 25 (80.6 %) and 6 (19.3 %) patients, respectively. Out of 12 patients with N1–3 tumors, there were 5 (41.7 %) and 5 (41.7 %) persons who showed complete and partial responses, respectively. Five-year overall survival was 88.2 % for patients with Т3N0 and 62.1 % for those with Т4N1–3. The local control of T3 and T4 was 88.2 and 77.8 %, respectively; the regional control of N1–3 was 33.3 %. Late laryngeal edema and perichondititis developed in 4 (12.9 %) and 3 (9.7 %) patients, respectively.