Individual approach to the treatment of patients with stage III–IV laryngeal and laryngopharyngeal cancer in the Altai territory

Laryngeal and laryngopharyngeal cancer is the most common malignancy within the head and neck. Although there are many treatments for laryngeal and laryngopharyngeal cancer, the treatment still faces great challenging.

The aim of the study was to evaluate the effectiveness of personalized treatment and one-year recurrence-free survival in patients with stage III–IV laryngeal and laryngopharyngeal, including postoperative complications (VTE, bleeding) within a year.

Material and Methods. From July 2022 to October 2023, 100 patients with stage III–IV laryngeal and laryngopharyngeal cancer were treated in the Department of Head and Neck Tumors at the Altai Regional Oncology Center (AROC), Barnaul. There were 95 men (95 %) and 5 women (5 %). Patients were divided into two groups. Group I patients (n=50) with locally advanced laryngeal cancer underwent laryngectomy followed by radiation therapy with a total dose of 54 Gy delivered to the bed of the removed tumor and lymph node drainage region. Group II patients (n=50) received 3 courses of chemotherapy followed by radiation therapy at a dose of 70–74 Gy.

Results. In group I patients, clinically insignifcant bleeding from the upper third of the trachea (in the area of contact with the tracheostomy tube) was observed in 3 patients (6.0 %) 3–4 days after surgery. No VTE during hospital stay and within 6–12 months after completion of treatment was observed. The 1-year cumulative survival rate in this group of patients was 90.0 %. In group II patients receiving chemotherapy, bleeding from a pharyngeal tumor was detected in 4 (8.0 %) patients. There were no signs of VTEO in this group. The 1-year cumulative survival rate of these patients was 70 %.

Conclusion. Patients with laryngeal/laryngopharyngeal cancer require an individual approach not only in determining therapeutic strategies, but also in the prevention of VTE and hemorrhagic complications.

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