Definitive radiotherapy for carcinoma in situ of the true vocal cords.
OBJECTIVE
To report long-term rates of tumor control after radiotherapy (RT) for carcinoma in situ (CIS) of the true vocal cords (TVC).


METHODS
Thirty-seven patients with CIS of the TVC were treated curatively with megavoltage RT between July 1967 and December 2005. Most patients (28/37) were treated with cobalt-60; the remainder were treated with 2- to 6-MV photons. Small (usually 5 x 5) fields were used. Median RT dose was 60.0 Gy (range, 56.25-66.50 Gy; mean dose, 59.55 Gy) at 2.25 Gy per fraction. Approximately two-thirds of the patients (23/37) were referred for RT because of a recurrence after at least 1 stripping procedure.


RESULTS
With a mean follow-up of 9.5 years (range, 2-25 years), the 5-year rates of local control, local control with larynx preservation, and ultimate local control (including salvage surgery) were 91%, 91%, and 91%, respectively. Invasive squamous cell carcinoma developed in 4 patients (11%). Time to failure was 6 months, 12 months, 48 months, and 13 years. Two patients were surgically salvaged with a total laryngectomy, 1 with transoral laser excision, and 1 patient declined further treatment. Cause-specific survival at 5 years was 100%. No late complications were noted.


CONCLUSIONS
RT to approximately 63 Gy at 2.25 Gy per fraction, using small (5 x 5 cm) fields produces excellent results in patients with CIS of the TVC.
Sengupta
Neil
N
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida 32610, USA.
Morris
Christopher G
CG
Kirwan
Jessica
J
Amdur
Robert J
RJ
Mendenhall
William M
WM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology / Q000528:radiation effects*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology / Q000528:radiation effects*