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

Year 2019, Volume: 1 Issue: 1, 35 - 41, 18.03.2019

Yurday Ozdemir , Erkan Topkan

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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