58. Influence of total time of surgery and postoperative radiotherapy on the outcome patients with advanced laryngeal carcinoma

Aim To evaluate influence of total time of combined treatment on locoregional outcome of treatment in group patients with larynx cancer. Material/Methods We performed retrospective analysis of 254 patients with with stage III or IV squamous cell carcinoma of larynx who were treated between 1993 and 1996. There were 236 men, 18 women, median age was 56.3 years. Surgery consisted of total laryngectomy and elective/selective neck dissection. Patients postoperativly were irradiated in coventional way with total dose of 60 Gy. We used shrinking field technique with lateral opposed photon fields to tumor bed and upper-mid neck nodes. Supraclavicular regions (lower neck lymph nodes) were treated with an anterior field. Total time of combined treatment (from the surgery to the end of radiotherapy) was an average 92 days (range, 65–131 days). The interval between surgery and the beginning of radiotherapy was an average 45 days (range, 22–78 days) and time of irradiation was an average 45 day (range, 40–74 days). Results Prolongation overall time of combined treatment beyond 90 days is strongly correlated with decreasing of locoregional outcome of treatment (p=0.00036). Also decreasing in outcome of treatment was noted when interval time between surgery and beginning of radiotherapy was more than 50 days (p=0.022) and when the time of irradiation was longer than 44 days (p=0.0026). Conclusions Decreasing of total time of combined treatment (surgery and postoperative radiotherapy) is crucial in patients with advanced cancer of larynx.