Chondroradionecrosis of the larynx: 24-year University of Wisconsin experience

Head Neck. 2017 Jun;39(6):1189-1194. doi: 10.1002/hed.24749. Epub 2017 Mar 11.

Abstract

Background: Chondroradionecrosis (CRN) is an uncommon but significant complication of laryngeal radiotherapy that presents a diagnostic challenge to clinicians through its similarity in presentation to cancer recurrence.

Methods: Two hundred ninety-four patients underwent primary, adjuvant, or salvage radiation for laryngeal cancer from 1991 to 2015 at the University of Wisconsin. Medical records were reviewed to identify and characterize patients with a diagnosis of CRN.

Results: Of the 294 patients, 7 cases (2.4%) of CRN were identified. Development of CRN was associated with the presence of cartilage invasion by tumor (p = .038) and ongoing alcohol use postradiotherapy (p = .036). Additionally, a trend between development of CRN and ongoing smoking postradiotherapy was observed (p = .067).

Conclusion: The diagnosis of CRN is challenging, and the likelihood of successful resolution is modest. A high premium should be placed on efforts directed at prevention, such as tobacco and alcohol cessation. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1189-1194, 2017.

Keywords: chondroradionecrosis; larynx; radiation; radiation injury; radionecrosis.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Cohort Studies
  • Databases, Factual
  • Female
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / methods
  • Larynx / radiation effects*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / radiotherapy*
  • Prognosis
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / mortality
  • Radiation Injuries / therapy
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant / adverse effects
  • Radiotherapy, Adjuvant / methods
  • Rare Diseases
  • Retrospective Studies
  • Risk Assessment
  • Salvage Therapy / methods*
  • Severity of Illness Index
  • Survival Analysis
  • Wisconsin