MORBIDITY OF COMBINED THERAPY FOR THE TREATMENT OF SUPRAGLOTTIC CARCINOMA - SUPRAGLOTTIC LARYNGECTOMY AND RADIOTHERAPY

Many surgeons find that patients have increased morbidity after suprag lottic laryngectomy if postoperative irradiation is given, but this re mains poorly documented. Twenty-nine patients undergoing supraglottic laryngectomy were retrospectively reviewed. Seventeen received postope rative radiotherapy, and 12 did not. The mean follow-up was 64 months. When compared to patients treated with supraglottic laryngectomy alon e, irradiated patients had a significantly higher incidence of lifelon g gastrostomy dependency (35% versus 0%; p = .03) and acute upper airw ay obstruction (29% versus 0%; p = .05). There was a trend toward grea ter tracheotomy dependency (24% versus 0%), aspiration pneumonia (35% versus 9%), and delayed independent swallowing (34.8 weeks versus 7.8 weeks) in the patients treated with combined therapy, but this differe nce was not significant. A morbidity index score was developed to eval uate the overall lifelong morbidity of these patients, and this was fo und to be significantly higher in patients treated with surgery and ra diotherapy (2.29 versus 0.83; p = .04). Overall survival was equal in both groups. We have shown that radiotherapy increases the morbidity o f supraglottic laryngectomy. This should be considered when planning t reatment for patients with supraglottic carcinoma.