[Results of radiotherapy in elderly patients with early laryngeal cancer].

UNLABELLED: Evaluation of the results of radiotherapy in elderly patients with early laryngeal cancer, the relation between comorbidities and the overall treatment time, and the influence of treatment interruptions on the outcome of treatment.

MATERIALS AND

METHODS

A clinical retrospective analysis of a group of 117 patients (over the 70 years old) with early laryngeal cancer was carried out. Patients were irradiated between the years 1980 and 2000 in the Centre of Oncology in Cracow. The analysed group consisted of 105 men (90%) and 12 women (10%). Patients' age ranged from 70 to 87 years, median - 73 years. Most of them had various comorbidities. Three different irradiation techniques and fractionation schemes were used according to the site, stage and grade of cancer: two oblique beams including the larynx with total dose of 60 Gy in 24 fractions (46 patients), two parallel opposing beams including the larynx and cervical lymph nodes with total dose of 60 Gy in 30 fractions (38 patients), and mixed photon-electron unilateral beam including the larynx with total dose of 60 Gy in 30 fractions (33 patients).

RESULTS

The median follow-up was 48 months. During the follow-up period 78 patients (66.6%) died. Among them 29 patients (37.2%) died of laryngeal cancer, 6 (7%) patients of other malignancy, and 43 (55%) patients died of concomitant diseases without evidence of cancer. The actuarial 5/10-year overall survival (OS) and disease specific survival (DSS) were 51%/23% and 77%/68%, respectively. The overall tolerance of radiation therapy was good; only 3 patients had G3 early mucosal reaction, and 1 patient had G3 early skin reaction were observed. Comorbidities were not demonstrated to have statistically significant influence on DSS rate. In 6 (5.1%) from 117 patients complete tumor regression was not achieved after radiotherapy. During the follow-up period loco-regional relapse were observed in 27 patients (23.5%), and distant metastases in 2 patients (1.7%).

CONCLUSIONS

Radiotherapy of the elderly patients with laryngeal cancer is effective and well tolerated method. Comorbidities do not significantly influence the treatment results. T stage, localization in supraglottic area, age over 73 years old, fractionation dose under 2 Gy and overall treatment time over 43 days are statistically significant negative prognostic factor for DSS rate.