Early laryngeal cancer.
For early-stage laryngeal cancer, both surgery and radiotherapy are effective treatment modalities, offering a high rate of local control and cure for this select group of patients. The probability of obtaining local control for early glottic cancer is similar when comparing the results of radiation therapy, cordectomy, and hemilaryngectomy. Radiation therapy has been the treatment of choice for all previously untreated T1 and T2 vocal cord cancers at our institution. We currently treat most patients with irradiation and consider transoral laser excision for the small subset of patients with well-defined T1 tumors that are limited to the mid-third of the cord. In this area, excision will not significantly diminish voice quality. Stage I and stage II supraglottic cancers may be treated with either radiation therapy alone or with a supraglottic laryngectomy with bilateral selective neck dissections (levels II-IV). In experienced hands, transoral laser excision also is an acceptable alternative for selected lesions. Overall, approximately 80% of patients at our institution are treated initially by irradiation.
Hinerman
Russell W
RW
Department of Radiation Oncology, University of Florida Health Science Center, PO Box 100385, Gainesville, FL 32610-0385, USA. hinerrw@shands.ufl.edu
Mendenhall
William M
WM
Amdur
Robert J
RJ
Villaret
Douglas B
DB
Robbins
K Thomas
KT
D015438:Health Behavior; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D007830:Larynx / Q000601:surgery; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D012307:Risk Factors; D019966:Substance-Related Disorders; D016019:Survival Analysis