[Percutaneous and interstitial radiotherapy in the function-preserving treatment of laryngeal carcinoma]

Since September 1986 an Ir-192 source with a high dose rate has been used for interstitial boosting of the tumor-bearing vocal cord in the organ-preserving management of larynx carcinoma. The combined percutaneous and interstitial treatment has been administered either as the primary treatment or after incomplete removal of the tumour (stripping). So far 16 patients with 18 vocal cord tumors have been treated. 9 patients presented with a T1-tumour, and 7 patients presented with a T2-stage (2 patients presented with tumours on both cords). All patients refused surgical interventions, 4 of them refused cord stripping too. The treatment method included external radiotherapy with a dose of 4600 to 5000 cGy to the larynx. 1 to 2 weeks after external XRT an interstitial implant into the vocal cord was performed. Using 2 needles per cord, a boost dose of 1000 cGy was given to the tumour area. The median follow-up time is 21.3 months (range 5 to 49, calculated October 1990). So far no local or regional failures occurred. None of the patients had intra- or postoperative complications. All patients have preserved their voice, 2 of them present with a mild hoarseness. Concerning the late effects, 1 patient developed a mild submental edema, 1 patient presents with telangiectasia on the treated vocal cord. The number of patients is very low, but the psycho-social aspects of preserving the ability to speak is of high value.