Results of radiation therapy in early glottic carcinoma: multivariate analysis of prognostic and radiation therapy variables.

Abstract

A detailed retrospective analysis was performed with 103 patients who had T1 carcinoma of the glottic larynx and underwent radiation therapy between 1960 and 1987. Prognostic and radiation therapy variables were analyzed including sex; age; staging procedures; mucosal extent; histologic grading of tumor; field size; use of wedges; treatment of alternate fields versus both fields every day; nominal standard dose; time, dose, and fraction; dose per fraction; total radiation dose per fraction; total radiation doses; and the impact of cord stripping. Initial local control was 89%, and ultimate control after surgical salvage was 97%, with a 5- and 10-year adjusted survival of 98%. Univariate analysis indicated that larger field size (P = .04), histologic grade (P = .02), and treatment strategy (P = .08) were of some value in predicting recurrence. Multivariate analysis indicated that field size (P = .03) was the only significant variable in predicting local recurrence. These data confirm that radiation is highly effective in the treatment of early laryngeal cancer.

Three weeks radiotherapy for T1 glottic cancer: the Christie and Royal Marsden Hospital Experience

“…Reported local control rates for T1 glottic cancer treated with definitive radiotherapy vary between 80 and 95% [1,20,24,42,46] with surgical salvage increasing local control to 90-100%. The reasons for this wide variation have been attributed to a range of patient, tumour and treatment related factors; these are summarised in Table 3.…”

Supracricoid partial laryngectomy with cricohyoidoepiglottopexy in patients with radiation therapy failure

“…Primary radiotherapy as treatment for early cancer of the glottis has been the most used treatment modality due to its low morbidity and excellent prognosis [1,2]. Rate of recurrence is reported to be from 13 to 36% [3-6].…”

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

“…In fact, oncologists in North America have shown a major tendency in favor of radiotherapy during the last two decades, to the detriment of surgical intervention [13]. Its precise effectiveness is difficult to evaluate objectively, as publications from various institutions report 5-year survival rates varying from 67% to 97% [30,34]. A review of the international literature reveals that initial results are less positive than surgical treatment; they tend to improve, however, and are comparable when associated with partial or total laryngectomy for relapsing cases [22].…”