Different Factors May Affect Clinical Outcome of Early Laryngeal Cancer

Purpose: To evaluate the effect of patients, tumor and treatment-related variables on survival in patients with T1T2 N0M0 squamous cell carcinoma of the larynx who treated with radical radiotherapy. Material and Methods: Eighty-three patients with T 1 T2N0M0 squamous cell carcinoma of the larynx were analysed. Patients were treated with initial opposed lateral fields to treat the primary and draining lymphatic system then these initial fields were reduced for spinal cord shielding. Different dose and fractionations has been used (50Gy/15 fraction, 50Gy/ 20 fraction, 60Gy/30 fraction and 64Gy/ 32 fraction, 5 days/ week). The following factors were analysed: Age, sex, disease extent, treatment interruption for 1 to 2 days, delay to start radiotherapy, pretreatment Hb level, and dose per fraction. Results: Mean survival was 8.49 years with STD 5.061. On univariate analysis, there is no significant survival difference regarding to sex, stage, radiotherapy dose received, treatment interruption for 1 to 2 days, as well as the delay to start radiotherapy (mean delay in days 56.84 days). However, there is statistical significant adverse survival outcome with increasing age (p<0.001). On the other hand, patients with pretreatment Hb level >12g/dl had significant statistical survival benefit over those ≤ 12g/dl (p=0. 0 18). Multivariate analysisof different prognostic factors and its impact on overall survival. Ten years increase in age was associated with increase in the hazard ratio by 138% (2.38 times) ( p<0.001). Also, every one gram increase in pretreatment Hb level reduce mortality risk with hazard ratio 25% (p=.03 1). However, each month delay to start treatment reduce hazard ratio by 28%. Conclusion: Pretreatment hemoglobin level and age had a significant effect on survival in patients with early laryngeal carcinoma treated with radical radiotherapy. Sex, disease extent, treatment interruption for 1 to 2 days, time to start radiotherapy, and different dose/fractionations did not affect the overall survival.