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Surgical Salvage for Radiation Failure

Alan J. Fisher, MD; David D. Caldarelli, MD; Donna C. Chacko, MD; Lauren D. Holinger, MD

Arch Otolaryngol Head Neck Surg. 1986;112(5):519-521.

Abstract
• Radiation therapy is a well-established treatment for early squamous cell carcinoma of the glottic larynx. However, the management of patients suspected to have persistent or recurrent disease may present both diagnostic and therapeutic dilemmas, particularly when laryngeal edema persists months after conclusion of radiation therapy. We reviewed the outcome of 212 patients with T1s, T1, and T2NOMO carcinoma of the glottic larynx who had been treated for cure with radiation therapy, with surgical salvage reserved for radiation failures. Twenty-four patients (11%) had recurrences after radiation therapy, 13 (59%) of whom had successful salvage by surgery. The five-year, recurrence-free survival in this series was 92% for T1s and T1 and 69% for T2. We conclude that T1s, T1, T2NOMO carcinoma of the glottic larynx is effectively managed by radiation therapy and surgical salvage for radiation failure. Total laryngectomy usually was necessary for surgical salvage.

(Arch Otolaryngol Head Neck Surg 1986;112:519-521)

Author Affiliations
From the Department of Otolaryngology and Bronchoesophagology, Rush Medical College, Chicago (Drs Caldarelli and Holinger), and the Palms of Pasadena Hospital, St Petersburg, Fla (Dr Chacko). Dr Fisher is in private practice in Pasadena, Calif.

Footnotes
Accepted for publication Sept 4, 1985.

Read before the 25th anniversary meeting of the American Society for Head and Neck Surgery, Palm Springs, Calif, March 10, 1983.

Reprint requests to Department of Otolaryngology and Bronchoesophagology, Rush-Presbyterian—St Lukes Medical Center, 1753 W Congress Pkwy, Chicago, IL 60612 (Dr Caldarelli).

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