Locally advanced laryngeal cancer treated by radiotherapy: A survival analysis of 107 cases

Objective To analyze the clinical results of 107 patients with locally advanced laryngeal cancer treated by radiotherapy n Chinese PLA General Hospital. Methods One hundred and seven newly diagnosed laryngeal cancer patients of stage Ⅲ or Ⅳ were treated with radiotherapy from May 2007 to April 2013. Three-dimensional conformal radiotherapy(3DCRT) (35.5%) and ntensity modulated radiation therapy (IMRT)(64.5%) were used in the study. The prescription dose was 50-60 Gy to the high risk arget and 44-54 Gy to the low risk target. Seventeen cases with no surgery and 10 cases of incomplete resection underwent radical adiotherapy. The prescription dose of residual tumor or metastatic lymph node target region was 64.5-70 Gy. Acute side-effects were valuated following the established RTOG/EORTC criteria. Results The median follow up time was 31.8 months (range, 4 to 76 months). The incidence rate of skin toxicity, oral mucositis and esophagitis - tracheitis was 99.1%, 84.1% and 77.6%, respectively. Until May 2014, there were 32 cases had treatment failure and 26 cases died. Of all the died patients, 23 died of tumor-related factors nd 3 died of other factors. The local relapse-free survival (LRFS), regional relapse-free survival (RRFS), distant metastasis-free urvival (MFS) and overall survival (OS) were 78.5%, 95.2%, 88.9% and 75.7% for 3 years. The clinical stage was an independent actor for the 3-year LRFS and tumor location could affect 3-year MFS, while the different surgical methods did not show infuences on the survival. Conclusion Radical chemoradiotherapy is a good choice for patients unft for surgery or be willing to reserving aryngeal function and salvage surgery is effective for the failure cases.