Radiation therapy for management of t1-t2 glottic cancer at a private practice.
OBJECTIVE
The purpose of this study was to retrospectively analyze patients with T1-T2N0 squamous cell carcinomas of the glottic larynx treated at a private institution, to review the pertinent literature, and to compare our outcomes to those of academic institutions.


METHODS
A total of 118 patients were treated with radiation therapy between May 1987 and August 2006 at a private institution and followed up for ≥2 years. Three patients were lost to follow-up between 18 and 19 months.


RESULTS
The 5-year local control rates were: T1a, 91%; T1b, 95%; T2a, 96%; and T2b, 100%. The 5-year ultimate local control rates after irradiation and including patients who were successfully salvaged with surgery after a local recurrence were: T1a, 94%; T1b, 100%; T2a, 96%; and T2b, 100%. Eight (7%) of the 118 patients developed a local recurrence. There were no isolated regional or distant recurrences. The 5-year overall survival rates were: T1a, 73%; T1b, 78%; T2a, 62%; and T2b, 69%. The 5-year cause-specific survival rates were: T1a, 96%; T1b, 100%; T2a, 100%; and T2b, 100%. Two patients experienced severe complications.


CONCLUSIONS
Patients with limited T1aN0 cancers may be treated with either transoral laser excision or RT. Those with more advanced T1-T2N0 cancers are treated with definitive RT. We do not advocate elective nodal irradiation, even for those with bulky T2B malignancies. The addition of concomitant weekly cisplatin 30 mg/M² is considered for patients with T2B cancers. Open parotid laryngectomy is reserved for salvage of suitable patients with a local recurrence.
Jones
D Adam
DA
Department of Radiation Oncology, Phoebe Putney Memorial Hospital, Albany, Georgia, USA.
Mendenhall
Charles M
CM
Kirwan
Jessica
J
Morris
Christopher G
CG
Donnan
Andrew
A
Holwerda
Scott
S
Kraus
S Terry
ST
Mann
Christopher J
CJ
Grant
John R
JR
Donnan
Benjamin
B
Mendenhall
William M
WM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology / Q000528:radiation effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011331:Private Practice; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome