One hundred and one cases of early and late supraglottic tumors covering a period of 22 years have been evaluated. The early stages, without lymph node metastasis, show a 75% 2‐year control and a 50% 5‐year survival. The local control rate is 75% in those patients treated at a dose equivalent to more than 1700 rets. More advanced supraglottic tumors with lymph node metastasis have shown a 15% 2‐year control rate, 10% 5‐year survival when treated with irradiation alone. We are now treating the more advanced tumors with clinical adenopathy with a course of preoperative irradiation of 4000 to 5500 rads in 5 to 6 1/2 weeks followed at an appropriate interval in all cases with radical surgical removal of the primary and draining node areas. Conservation surgery is being considered in the advanced cases as an alternative to total laryngectomy. Lesions without clinical nodes in the supraglottic area should be treated by radiation therapy alone. At least 6000 rads in 6 1/2 weeks should be delivered to the primary and node‐draining areas. Conservation surgery in these earlier cases can be reserved for radiation treatment failures, thus sparing the voice in 75% or more of the cured patients.
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