Primary radiotherapy of larynx and XXXX --an analysis of some factors influencing local control and survival.

@entity1 @entity135 @entity5 @entity189
An analysis of 950 @entity1 with @entity189 of the larynx and pharynx was performed to identify factors of importance for local control and survival other than the TNM-classification. All @entity1 were treated with primary radiotherapy, with doses ranging between 60-68 Gy in 6-7 weeks. The achievement of local-regional control by primary radiotherapy was highly correlated with disease-free survival (98% actuarial 5 year probability), which was significantly better than in @entity1 who failed in the primary treatment but were salvaged by radical surgery. Furthermore, occurrence of distant metastases were almost all associated with failure to control the @entity5 . Sex was found to be a dominant prognostic factor, and in all sites and stages, @entity1 had a significantly better prognosis both with regard to local control and survival. The degree of histopathological differentiation was not significantly correlated with local control but with the incidence of distant metastases, which was significantly higher in @entity1 with poorly differentiated @entity5 . In both males and females the pre-treatment hemoglobin concentration was correlated with the probability of @entity5 control and survival but only in @entity1 with pharyngeal and to a @entity5 . In these groups, @entity1 with hemoglobin levels above 13 g% (females) and 14.5 g% (males) had a significantly better prognosis than comparable @entity1 with lower hemoglobin values. Such correlation could not be detected in @entity1 with @entity5 . The influence of @entity5 size was analyzed in a larger group of 1,060 @entity1 with @entity189 . In this group a notable correlation between @entity5 size and prognosis was observed within the various T-categories, indicating the @entity5 size as a significantly important parameter related to both probability of local control and survival. The study reveals that @entity135 is a heterogeneous disease and it is demonstrated that attention should be given to the various prognostic parameters since important therapeutic achievement is otherwise lost.
