The retrospective assessment of prognostice factors of the patients who had radiotherapy for larynx cancer diagnosis

Introduction and Purpose: The incidence of larynx cancers in men is 2.2 % and 0.4 % in women but though it?s the most often cancer type of head and neck where it composes the 25 % of all head and neck cancers. In this study it was aimed to investigate the effects of the prognostic factors related to tumor, treatment and patient on local and regional control, overall survival and disease free survival.Material and Method: Forty six patients patients who admitted to İnönü University Radiation Oncology Department between November 2002 and May 2010 suffering from squamous cell cancer of larynx after surgical operation and adjuvant radiotherapy were analyzed retrospectively. The age of the patients, differentiation, stage and placement of tumor, T and N stage, lymphovascular, perineural and capsule invasion, surgical border, cartilage involvement, interruption during treatment and concurrent chemotherapy application were assessed.Results: The median age was 59 (37-80) ,and 44 of patients were male (97 %) and 2 of them were female (4 %). There were 25 patients (54 %) aged over 60 and 21 patients (46 %) under 60. In the histopathologic analysis of the tumor differentiation; 6 cases (13 %) were well differentiated, 32 (70%) were moderately differentiated and 8 cases (17%) were poorly differentiated. Fifteen patients (33 %) were in Stage III, 31 (67 %) were in Stage IV. Four patients (9 %) were evaluated as T2 stage, 16 (35 %) were T3 and 26 patients (57 %) were evaluated as T4 stage. 23 patients were N0 (50 %) and 23 were N1-2 stage.In the histopathologic analysis, 9 patients (20 %) had tumor in the surgical borders, 5 had (11%) tumour close to the surgical border, 30 had (65%) cartilage invasion, 13 had (28%) lymphovascular invasion, 8 (17%) had perineural invasion and 3 patients (7 %) had capsule invasion. Half of the patients had tumor in the glottic region and the rest had in the supraglottic region.In eight patients (17 %) an additional disease except larynx carcinoma was present. Three had hypertension and ischemic heart disease, one had chronic obstructive pulmonary disease, one had glaucoma, one had previous tuberculosis, one had surrenal adenoma and one had a gastric operation history.All of the patients had a history of smoking. The smoking habits were as follows:17 patients (%17) 40 package/year/day, 16 patients (%16) 30 package/year/day, 12 patients (%26) 20 package/year/day, 1 patient (%2) 10 package/year/day.All of the patients were treated by conventional methods. 44 patients received about 66 Gy external radiotherapy. Two patients received 46 Gy external radiotherapy because of the reason that they didn?t continue the treatment. Seven patients received concurrent chemotherapy and two had adjuvant chemotherapy.Conclusion: The five year overall survival was 66 % and disease free survival was found as 67 %. It was noticed that N stage (p=0.0001), capsule invasion (p=0.026) and cartilage involvement (p=0.047) had importance on overall survival. Besides, N stage (p=0.0001) and capsule invasion (p=0.034) were important for disease free survival. The results of multivariant analysis showed that, the effect of N stage (p=0.0001, p<0.05) was statistically significant on both the overall survival and disease free survival.Keywords: Radiotherapy, larynx cancer, overall survival, disease free survival