title: The influence of field size, treatment modality, commissure involvement and histology in the treatment of early vocal cord cancer with irradiation.
abstract: One hundred and thirty-seven patients with TNM staged T1 glottic cancer were treated from 1966 to 1980. The patient characteristics were no different from those noted in previous studies. Patients were treated either with 60Co teletherapy units or 4 MeV linear accelerators with different daily (180-225) and weekly (4 times vs. 5 times) fractionation schemes. A recurrent-free survival was attained in 80% of the patients 2 years after primary treatment with radiation therapy. There were 27 local recurrences, of which 82% were salvaged with surgery for an overall adjusted survival of 95%. Patients treated on 60Co units with field sizes less than or equal to 30 sq. cm had a 15% increase in local recurrence compared with field size greater than 30 sq. cm, which could not be attributed to lower doses. Poorly differentiated tumors and those involving the anterior commissure were more likely to develop a local recurrence. Doses above 1900 ret were associated with a decrease in local recurrence in patients having anterior commissure involvement. Salvage with limited surgery for failure was effective in selected cases.
mesh_terms: D000328:Adult; D000368:Aged; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010315:Particle Accelerators; D011867:Radioisotope Teletherapy; D011882:Radiotherapy, High-Energy; D012907:Smoking; D014827:Vocal Cords
chemical_list: D003037:Cobalt Radioisotopes