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Vocal cords paralysis

Question
43 out of 58
 

Treatment of choice in stage III carcinoma larynx is: (AIIMS May 2011)



A Chemotherapy
B Surgery + radiation

C Surgery + chemotherapy
D Only radiotherapy

Ans. B Surgery + Radiation

Treatment of Ca Larynx

Stage

Site

Treatment

T1

T2

T3 andT4

All site

Glottic and subglottic lesion Supraglottic lesion

All sites

External beam radio therapy/Microlaryngeal surgery

Radiotherapy

Supraglottic laryngectomy

Total laryngectomy with neck dissection for clinically positive nodes and post operative radiotherapy

if nodes are not palpable

According to current otolaryngology 21e pg- 446

Advance stage larynx cancer (stage III and IV) was historically treated by dual modality therapy with surgery and radiation.

Surgery done was - Total laryngectomy

But Now

In stage III - Organ preservation surgery along with radiation (radiotherapy + chemotherapy) has become a standard of care in most centres.

Note

Chemotherapy used is - 3 cycles of Cisplatinum and 5-FU

In stage IV - organ preservation surgery is not useful because of cartilaginous invasion. Hence in stage IV. Total laryngectomy with radiotherapy

is still being done.

As per the options given in the question - there is no such option as surgery + chemoradiation Hence we are going with surgery + Radiotherapy as TOe in stage III cancer.

Vocal cords paralysis Flashcard List

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