Radiation therapy for advanced (T3T4N0-N3M0) laryngeal carcinoma: the need for a change of strategy: a radiotherapeutic viewpoint.

Since 1974 through 1984, 137 selected patients with loco-regionally advanced carcinoma of the larynx (T3T4 N0-N3) were treated primarily with quality controlled high dose megavoltage radiation therapy with salvage surgery in reserve. This policy of treatment has yielded 67% loco-regional control probability with primary radiotherapy and 85% with salvage surgery at 3 years. Fourteen patients (14/38) had moderate to severe complications after salvage surgery. The quality of life of the patients successfully treated by radiation therapy is obviously and unquestionably better. Primary radiotherapy with salvage surgery in reserve should be accepted as the strategy of choice in at least a selected group of patients with advanced laryngeal carcinoma.