[Time factors in postoperative radiotherapy in the years 1986-19990 and 2000-2002]

Postoperative radiotherapy plays an important role in management of advanced laryngeal cancer. Numerous retrospective data has given strong evidence that prolongation of treatment time of radiotherapy has negative influence on treatment results. Generally, it might be concluded that each additional day of irradiation is connected with drop of locoregional control in range from 1% to 2%. In this paper, the duration time and frequency of gap which occurred during postoperative radiotherapy of the laryngeal cancer in the following two time periods were compared: 1986-1990 (group I) and 2000-2002 (group II). An analysis indicated that in the I group of patients gaps during the course of postoperative radiotherapy were noted in 52% (160/311 patients) and in the group II in 26% (71/270 patients). The median time of the gap dropped from 8.3 days to 4.2 days. In the same time the percentage of gaps due to acute side effects was reduced from 30% (94/311) to 9% (24/270) and in addition the reduction of the time of gaps by 4.1 days was observed. The significant reduction of the time of gaps due to breakdown of therapeutic machine was observed, but the number of gaps with this reason was generally low. In the II group of patients treated in years 2000-2002 the percentage of gaps caused by holidays increased from 10% (33/3110) to 14% (39/270). The median time of gap in the same time was lowered by 1 day. In conclusion, during the last decade, the length of the postoperative radiotherapy for patients after total laryngectomy due to advanced laryngeal cancer was reduced. Still is a place for additional time reduction of gap by intensification of patient's medical care during irradiation and logistic improvement in patient's care.