Combined laryngeal conservation surgery and irradiation: can we expand the indications for conservation therapy?

Thirty-nine patients (median age of 60 years) with carcinoma of the supraglottic larynx (N = 16), vocal cord (N = 4), and hypopharyngeal wall and pyriform sinus (N = 19) were treated by combined conservation surgery and radiation therapy. Thirty-three patients had postoperative treatment, and the remaining six were given preoperative irradiation. The plan was chosen because of clinical and pathologic features known to be fraught with a high incidence of recurrence above the clavicles. Long-term complications occurred in six patients, two of whom died of aspiration pneumonia. Thirty-eight patients completed their treatment and have been followed for a median of 48 months (1 1/2 to six years). Survival rates are 56% and 63% for absolute and determinant cases, respectively.