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At least 199 records · Page 11Linked to original sources
PubMed1995

[Radiotherapy of stage T1 carcinoma of the glottis. Analysis of prognostic factors in 154 patients].

A retrospective study was carried out on a series of 154 patients affected with vocal cord cancer in stage T1 treated with definitive radiotherapy April, 1979, to November, 1991. According to the 1992 TNM classification (UICC), 121 patients were classified as stage T1a and 33 patients as stage T1b. All patients were treated using parallel opposed fields of a 60 cobalt unit. Field size ranged from 16 to 30 square centimeters and the dose from 4400 to 7000 cGy, but only 15 patients received less than 6400 cGy. All patients were treated with once-daily fractionation (200 cGy/day). Follow-up ranges from 25 to 123 months; the median is 63 months. We observed 14 local recurrences (9.0%), all but one within 36 months from the end of treatment. Ten of 14 patients (71.4%) were rescued by surgery (8 patients underwent total laryngectomy and 2 conservative surgery); 13 patients were lost for intercurrent deaths. The incidence of recurrences is 7.4% for T1a patients (9/121) and 15.1% for T1b patients (5/33). The total dose does not seem to be related to relapse rate since recurrences were found in 6.6% of patients after a dose < 6400 cGy and in 9.3% of patients who had received higher doses. In our experience, field size did not affect, treatment results (< 25 cm2: 7.5% recurrences, > 25 cm2: 10.7%). Besides lesion volume, the main prognostic factor was overall treatment time. The incidence of failure was 3 times lower (5.8%) in the patients who completed the treatment within 7 weeks than in the patients whose treatment lasted more than 8 weeks (16.6%).

Adult↗
PubMed1993

[Horizontal laryngectomy of the glottis].

The surgical technic of horizontal glottic laryngectomy and the oncological and functional results in 12 cases treated in ENT Clinic of Pomeranien Medical Academy in Szczecin during the years 1985-1991 are presented. In all cases the changes concerned the vocal cords and were of following extend: T1b--5 cases and T2--7 cases. The survival rate was: 5-years--4/6 patients, 3-year--8/10 patients and 1-2-years--2/2 patients. 3 patients died. The causes of death were: intraoperation--1 case, local recurrence--1 case and non neoplastic case--1 case. Among 12 cases decaniulation were possible in 9.

Adult↗
PubMed1993

[Partial surgery of epitheliomas at the level of the glottis. An update].

Seven hundred and thirty three patients with glottic squamous cell carcinoma were treated with partial laryngeal surgery at our institution over a sixteen years period of time. Three hundred and ninety four patients were operated from 1972 through 1980 and three hundred and thirty three from 1980 through 1988. This retrospective study analyse local failure according to the surgical technique performed. Surgical technique was either a thyrotomy, a vertical partial laryngectomy or a supracricoid laryngectomy with cricohyoidoepiglottopexy. Among the 394 patients treated from 1972 through 1980, local failure was reported according to the T stage, the precise tumor location within each stage, the true vocal cord mobility and the surgical procedures. There was a diverse group of lesions within each T stage that responded differently to the surgical approaches. The differences in the local recurrence rates are discussed in terms of careful preoperative assessment and choice of surgical technique. This study support the premise that the choice of the surgical technique requires accurate preoperative assessment of tumor extend and laryngeal mobilities.

Carcinoma↗
PubMed1993

[Laser and glottis excision].

The CO2 laser is being used in several department for primary treatment of limited vocal cord carcinoma. The surgical resection is not the same in several department. One speaks of vaporisation, laser excision, cordectomy, deep cordectomy. The purpose of this paper is to definitive 3 types of laser surgery for glottic cancer = partial cordectomy, cordectomy with exposition, enlarged cordectomy. This classification allow to know with precision the importance of the surgical resection in each case.

Glottis↗
PubMed1993

Effect of age and bolus variables on the coordination of the glottis and upper esophageal sphincter during swallowing.

We studied 1) the effect of age and bolus variables on a) the coordination of deglutitive vocal cord adduction and upper esophageal sphincter (UES) relaxation and b) the duration of deglutitive vocal cord adduction; 2) the effect of the presence of a manometric catheter across the UES on the deglutitive glottal function; and 3) the temporal relationship between deglutitive vocal cord closure and swallow-induced apnea. We studied 10 young (23 +/- 2 yr) and 10 healthy elderly (73 +/- 2 yr) volunteers by concurrent videoendoscopy, UES manometry, respirography, and submental surface electromyography. In both groups the onset of vocal cord adduction preceded the onset of UES relaxation, deglutitive apnea, and submental electromyogram swallowing signal. In both groups, bolus volume and temperature did not have any significant effect on the duration of deglutitive vocal cord adduction. In both young and elderly volunteers, water swallows, compared with dry swallows, significantly shortened the interval between the onset of deglutitive vocal cord adduction and the onset of UES relaxation. In conclusion, coordination between deglutitive glottal and UES function, as well as the duration of deglutitive vocal cord adduction, is preserved in the elderly. Bolus volume and temperature do not have a modulatory effect on the duration of vocal cord closure, but water swallow shortens the interval between the onset of glottal closure and UES relaxation. This shortened interval may contribute to the safety of the airway during swallowing of liquid volumes.

Adult↗
PubMed1995

[Radiotherapy of T1N0 neoplasms of the glottis. Analysis of the parameters that influence local control].

Treatment and tumor-related parameters were reviewed in 176 patients with T1N0 carcinoma of the glottic larynx submitted to primary radiation therapy from 1980 to 1992. Our aim was to analyze local control and treatment-related toxicity. Over-all local control rates at 10 years were 88.3% with irradiation alone and 94.5% after salvage surgery (larynx preservation: 91%). Verrucous histology was a negative factor affecting local control and anterior commissure involvement exhibited only a negative trend but had no statistical significance. Among treatment-related factors, local control was 76.5% after split-course and 91.1% after continuous-course irradiation (p < 0.05). With continuous-course irradiation, the total dose influenced local control only for single of 2 Gy (local control rates were 69% with 60 Gy and 93% at > or = 64 Gy; p < 0.05), but not for single doses of 2.25 Gy and total doses ranging 56.25-65.25 Gy (local control failed in 55 patients). Early and late complications did not increase with single doses > or = 2.25 Gy. Our current policy in T1N0 nonverrucous glottic carcinoma is to use a single fraction of 2.25 Gy and a total dose ranging 56.25-63 Gy according to tumor size, with a continuous course.

Actuarial Analysis↗