Abstract
Radiotherapy, laser surgery or a combination of the two have offered patients with early laryngeal cancer a chance for survival without total loss of vocal function, but there is still much controversy in their selection. Treatment of T1a glottic carcinoma with laser surgery alone has been reported to have a cure rate in the vicinity of 90% which is close to or superior to that achieved with radiation therapy alone. This however is not the case in T1b glottic carcinoma and T2 glottic or supraglottic carcinoma, and pre-or postoperative irradiation is often incorporated in an attempt to improve local control. We have shown in a series of 72 patients with early laryngeal cancer that radiotherapy combined with laser surgery may result in delayed healing of the wound, leaving ulcers with white exudate and granulation which are highly problematic in evaluating the lesion. Coated ulcers were seen 2 months after completion of therapy in 14 of the 28 cases (50.0%) that underwent irradiation following laser surgery, while only 6 of the 24 cases (25.0%) treated with laser alone, and only 1 of the 12 cases (8.3%) treated with radiation alone had delayed healing.
