Radionecrosis or tumor recurrence after radiation of laryngeal and hypopharyngeal carcinomas |
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Authors: | Peter Zbren MD Marco Caversaccio MD Harriet C Thoeny MD Michel Nuyens MD Jürgen Curschmann MD Edouard Stauffer MD |
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Institution: | Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital, Berne, Switzerland. peter.zbaeren@insel.ch |
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Abstract: | OBJECTIVE: To analyze the incidence and diagnostic difficulties of radionecrosis vs tumor recurrence of laryngeal and hypopharyngeal carcinomas. STUDY DESIGN AND SETTING: Retrospective study on 341 patients treated by radiation alone or radiochemotherapy. The clinicopathologic findings, work-up, treatment, and follow-up of 20 patients with symptoms suggestive but negative for tumor recurrence on initial imaging studies and endoscopy were analyzed. RESULTS: The incidence of chondroradionecrosis in 341 irradiated patients was 5%. Ten of 20 patients initially negative for tumor recurrence were treated by total laryngectomy; in all laryngectomy specimens, chondroradionecrosis was present, in six specimens associated with tumor recurrence. Ten patients were treated by tracheotomy and tumor recurrence was detected in one patient during follow-up. CONCLUSION: Chondroradionecrosis is a relatively rare treatment complication. Typical imaging findings suggestive of radionecrosis are often missing. Tumor recurrence may be present beneath an intact mucosa and missed by endoscopy. |
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