New Modalities to Treat Laryngeal Cancer

Early laryngeal cancer comprises T1 and T2 stages of the disease. Open functional operations achieve local control of the disease in 90–95% of T1 patients and in 70–90% of T2 patients. Primary RT achieves local control in 85–94% of T1 tumors and in 70–80% of patients with T2 tumors. Introduction of endoscopic laser surgery resulted in further popularization of preservation laryngeal surgery, whereby equally successful treatment results are achieved with minimal invasiveness. Quality of voice is also better after RT and laser resection. In the last century a golden standard of treatment of advanced laryngeal cancer (T3/T4 stage) was total laryngectomy (TL) with neck dissection followed by adjuvant RT. Overall 5 year survival was around 50%. Due to impact of TL on quality of life, »Larynx preservation strategy« (LPS) was developed in the early \u2790 for advanced stages of the disease. Novel approach is an introduction of targeted therapy, such as anti-EGFR monoclonal antibody, cetuximab. Concomitant cetuximab with RT achieves higher survival, and better locoregional disease control in comparison to administration of single RT modality. Therefore non-surgical methods of treatment of advanced laryngeal carcinoma are constantly changing and improving as new chemotherapeutics are being introduced into protocols. Uncritical enthusiasm with non-surgical methods of treatment resulted in higher incidence of treatment toxicities, higher rates of »salvage surgery« with more frequent adverse effects. That resulted in a consensus attempt around »LPS« project with reevaluation of clinical studies and uniform recommendations for future studies. When choosing appropriate therapy for oncological patient, quality of life (QOL) is a special category to be taken into account besides complications, pain, duration of treatment and overall benefit for the patient

A review of Zvonimir Krajina’s professional heritage in the light of the hundredth anniversary of the Department of Ear, Nose and Throat Diseases and Head and Neck Surgery of the Zagreb School of Medicine

Among the many great physicians who headed the Department for Ear, Nose and Throat Diseases and Head and Neck Surgery at the Zagreb School of Medicine a significant place belongs to profes- sor Zvonimir Krajina since his scientific and professional work was through his entire career centred around this department. He was elected Head of the Department in 1971, exactly half a century after its founding. Since then, he sought to enrich it with a series of innovations in professional and scien- tific areas, as well as make organisational changes in its management. Zvonimir Krajina was equally skilful in all areas of head and neck surgery. He developed rhinology and functional nose surgery, head and neck oncology, and especially functional laryngeal surgery. Besides running the Department, Professor Krajina was also the vice dean of the School of Medicine in the period of 1970 – 1974, and dean in 1974 – 1978. At the University of Zagreb, he was Head of the Committee on International Relations from 1978 – 1982, and in the period of 1982 – 1986 he was the rector of the University of Zagreb. He was a member of many international scientific societies and was a visiting professor at universities in Europe, USA and Japan. Professor Krajina was truly an exceptional person and doctor and we can claim with full conviction that Zvonimir Krajina is one of the representative personalities of Croatian otorhinolaryngology