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Title: Pharyngo-cutaneous fistulae after laryngectomy. Influence of previous radiotherapy and prophylactic metronidazole

The development of a pharyngocutaneous fistulae is a major complication after total laryngectomy. In Denmark radiotherapy is the primary treatment for all laryngeal carcinomas. Based on the experience with conventional daily irradiation, a split-course radiation schedule was introduced in 1978. The charts of 106 consecutive patients laryngectomized for recurrence in the years 1975 to 1984 were examined. Thirty-four patients developed a fistula. An evaluation of the different radiotherapy schedules used during this period allowed a dose-response curve to be constructed. It showed a pronounced increase of fistulae with high doses of radiotherapy. Split-course radiotherapy caused a rise in late complications and did not improve tumor control. Large field sizes increased the number of fistulae. High-dose fractions showed a surprisingly high incidence of late complications. Prophylactic metronidazole (introduced in 1980) resulted in a highly significant decrease in the frequency of postoperative fistulae. Patients in whom fistula formed were hospitalized for an average of 54 days, patients without, for 22 days.
Authors:
; ;
Publication Date:
OSTI Identifier:
5350335
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cancer (Philadelphia); (United States); Journal Volume: 61:4
Research Org:
Aarhus Univ. Hospital (Denmark)
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; CARCINOMAS; RADIOTHERAPY; LARYNX; METRONIDAZOLE; RADIOSENSITIVITY EFFECTS; SIDE EFFECTS; SKIN DISEASES; RADIOINDUCTION; DENMARK; DOSE-RESPONSE RELATIONSHIPS; FRACTIONATED IRRADIATION; LARYNGECTOMY; PATIENTS; RADIATION INJURIES; ALCOHOLS; ANTINEOPLASTIC DRUGS; AZOLES; BIOLOGICAL EFFECTS; BIOLOGICAL RADIATION EFFECTS; DISEASES; DRUGS; EUROPE; HETEROCYCLIC COMPOUNDS; HYDROXY COMPOUNDS; IMIDAZOLES; INJURIES; IRRADIATION; MEDICINE; NEOPLASMS; NITRO COMPOUNDS; NUCLEAR MEDICINE; ORGANIC COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; RADIATION EFFECTS; RADIOLOGY; RADIOSENSITIZERS; RESPIRATORY SYSTEM; SCANDINAVIA; SURGERY; THERAPY; WESTERN EUROPE 560151* -- Radiation Effects on Animals-- Man