Radiotherapy of supraglottic cancers. Report on 84 patients

: Ten of 84 supraglottic carcinomas were treated by primary surgery, 32 by pre or post operative irradiation and 41 by primary irradiation and salvage surgery if recurrence developed. A comparison of the treatment results between these groups is not possible because of the lack of randomization. After follow up of 4.4 years (range 0,1-19, 7 y) 44% of the patients had died of their primary tumour or complications of treatment, 22.5% had died of intercurrent disease and 11% of other malignancies. The actuarial 5-year survival in the pre/postoperatively irradiated group was 75%, 100% and 67% for Stage I-III respectively. None of the 13 patients in Stage IV survived 5 years. The actuarial 5-year survival for the Stage I-IV irradiated patients was 91%. 67%, 82% and 42%. If possible the primary treatment should preserve the larynx, which is of great importance for the patient's quality of life. With proper selection supraglottic laryngectomy is possible for certain tumours of Stage I and II. For more advanced tumours and those not suitable for partial laryngectomy, well planned curative irradiation should be given with "reducing field" technique allow for salvage surgery for radioresistant tumours or recurrences. A total dose of 62-72 Gy 5 x 2 Gy per week for 6-8 weeks is needed depending on the stage of the tumour. Preoperative irradiation in clearly operable tumours can be given with a short course of 5 x 5 Gy over 5 days as the method of choice. In doubtfully operable tumours conventional preoperative irradiation with 30-40 Gy in 3-4 weeks is preferable.