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The significance of laryngeal edema following radiotherapy of carcinoma of the vocal cord
Author(s) -
Fu Karen K.,
Woodhouse Robert J.,
Quivey Jeanne M.,
Phillips Theodore L.,
Dedo Herbert H.
Publication year - 1982
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19820215)49:4<655::aid-cncr2820490409>3.0.co;2-i
Subject(s) - medicine , laryngeal edema , edema , radiation therapy , cord , biopsy , larynx , surgery , carcinoma , radiology
Laryngeal edema persisting for more than three months following radiotherapy developed in 38 of 247 (15.4%) patients irradiated for carcinoma of the vocal cord. In 17 (44.7%) of these patients, the laryngeal edema was associated with persistent or recurrent disease, although only 25.4% of the patients with uncontrolled disease had laryngeal edema. The incidence of laryngeal edema was 13.1% for T 1 disease, 23.8% for T 2 , and 21.4% for T 3 and T 4 disease. It increased significantly with increase of minimum tumor dose ⩾ 7000 rad or with NSD > 1900 ret, being 46.2% with minimum tumor dose ⩾ 7000 rad and 13.7% with minimum tumor dose < 7000 rad and 43% with NSD > 1900 ret and 17% with NSD ⩽ 1900 ret. It also increased with increase of field size, being 13.4% with field sizes < 6.0 × 6.0 cm 2 , and 24.4% with field sizes ⩾ 6.0 × 6.0 cm 2 . When laryngeal edema is progressive and unresponsive to conservative measures, multiple biopsies should be performed to establish the presence of persistent or recurrent disease before salvage surgery is attempted. However, if it is mild, stable, no visible recurrence develops, and especially if it is limited to the arytenoids, no biopsy should be attempted because of the risk of inducing laryngeal necrosis.