Long-term results of radium contact irradiation in laryngeal carcinoma andtheir relevance for modern therapeutical regimes.

Background: Despite the fact that it is widely accepted that a second radio genic carcinoma might occur after radiotherapy of laryngeal carcinomas, the re are only a few long-term follow-up studies published yet. Methods: Betwe en 1973 and 1988 193 patients have been treated by radium contact irradiati on because of glottic cancer (Tcis, T1, T2). After the cancer had been diag nosed by biopsy, a partial resection of the thyroid cartilage in the shape of a window 16 x 18 mm was carried out and a self-retaining capsule which h arbours the radium was brought into position. Results: 190 (181 men and 9 w omen) out of 193 patients could be followed up. At the time of investigatio n 109 patients had already died, 66 intercurrently. The actuarial disease f ree survival rate 5 and 10 years for Tcis/T1 glottic cancers were 84.6 % an d 83.6 %. For T2 carcinomas a rate of 100% was found respectively. The actu arial overall survival Fate was 96.8 % after 5 and 93.1 % after 10 years fo r Tcis/T1 carcinomas. The T2 carcinomas revealed an actuarial overall survi val rate of 100% after 5 and 10 years. Conclusions: As the results of radiu m contact irradiation are not better than those which can be achieved by mi crosurgery or modern irradiation techniques no indication exists for a radi um contact irradiation of glottic laryngeal cancer today.