The Outcomes of Patients with T1n0m0 Glottic Laryngeal Carcinoma Undergoing Radical Radiotherapy

Abstract

Amaç: T1N0M0 glottik larenks kanseri (GLK) nedeniyle radyoterapi almış hastalarda sağkalım ve uzun dönem toksisite sonuçlarımız ve ilişkili faktörlerin araştırılması.

Gereç ve Yöntem: Ocak 2007-Mayıs 2017 arasında 64,4 Gy (2,3 Gy/fx) radyoterapi alan 90 hasta geriye dönük olarak analiz edilmiştir. Sağkalım analizleri radyoterapi son günü ve son kontrol/olay tarihi temel alınarak Kaplan Meire yöntemiyle hesaplanmış olup geç yan etkiler Radiation Therapy Oncology Group’un (RTOG) kriterlerine göre değerlendirilmiştir.

Bulgular: Ortanca takip süresi 57 ay (0-129 ay) olup 12 (%13,3) hastada relaps gelişmiştir: %11,1 lokal, %1,1 lokal-bölgesel ve %1,1 lokal-bölgesel-uzak şeklindedir. Takipte 14 hasta ölmüş ve ölüm nedenleri 7 (%50) larenks kanser (LK), 5 (%35,7) ikinci primer kanser (İPK) ve 2 (%14,3) kanser dışı sebeplerdir. Relaps gelişen 12 hastanın 7’si (%58,3) LK, 1’i (%8,3) İPK ve 1’i (%8,3) kanser dışı sebeplerden kaybedilmiştir. Genel, hastalığa özgü ve lokal relapssız 5-yıllık sağkalımlar sırasıyla %88,7, %94 ve %83,6’dır. İPK 11 (%12,2) hastada gelişmiş olup %81,8’i akciğer kanseridir. İPK’ya kadar geçen ortanca süres 44,5 aydır (aralık: 23-105). İPK’lı hastaların ortanca sağkalımları İPK’sı olmayanlara göre daha kötü olup (66 ay vs. ortanca değere ulaşılamamıştır; p=0,005), 5 yıllık sağkalım sonuçları (%72,7 vs. %91,3) şeklinde bulunmuştur. Toplam 1 hastada (%1,1) geçici trakeostomi gerektiren grad 3 larenks ödemi ve 1 (%1,1) hastada sol karotis arter darlığı gelişmiştir.

Sonuç: Erken evre GLK’lı hastalarda İPK ölüm sebebi açsından ana hastalıkla yarışır niteliktedir. Radyoterapiye bağlı gelişebilen karotis arter darlığının takip sürelerinin uzamasıyla daha ön plana çıkabileceği ön görülmektedir.

Keywords

• Glottic laryngeal carcinoma,radiotherapy,second primary malignancy

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