title: Single vocal cord irradiation: a competitive treatment strategy in early glottic cancer.
abstract: BACKGROUND
  The treatment of choice for early glottic cancer is still being debated; ultimately it relies on the functional outcome. This paper reports on a novel sparing 4D conformal technique for single vocal cord irradiation (SVCI).
  
  
  METHODS
  The records of 164 T1a patients with SCC of the vocal cord, irradiated in the Erasmus MC between 2000 and 2008, were analyzed for local control and overall survival. The quality of life was determined by EORTC H&N35 questionnaires. Also the VHI (voice handicap index), and the TSH (thyroid stimulating hormone) blood levels, were established. On-line image guided SVCI, using cone beam CT or stereotactic radiation therapy (SRT) techniques, were developed.
  
  
  RESULTS
  A LC rate at five-years of 93% and a VHI of 12.7 (0-63) was determined. It appeared feasible to irradiate one vocal cord within 1-2mm accuracy. This way sparing of the contralateral (CL) vocal cord and CL normal tissues, could be achieved.
  
  
  CONCLUSIONS
  Given the accuracy (1-2mm) and small volume disease (CTV limited to one vocal cord), for the use of stereotactic RT techniques SVCI with large fraction sizes is currently being investigated in clinic. It is argued that hypofractionated SVCI can be a competitive alternative to laser surgery.
authors.affiliation: Radiation Oncology Department, Rotterdam, Netherlands. p.levendag@erasmusmc.nl
authors.forename: Peter C
authors.initials: PC
authors.lastname: Levendag
authors.forename: David N
authors.initials: DN
authors.lastname: Teguh
authors.forename: Fatma
authors.initials: F
authors.lastname: Keskin-Cambay
authors.forename: Abrahim
authors.initials: A
authors.lastname: Al-Mamgani
authors.forename: Peter
authors.initials: P
authors.lastname: van Rooij
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Astreinidou
authors.forename: Stefan L S
authors.initials: SL
authors.lastname: Kwa
authors.forename: Ben
authors.initials: B
authors.lastname: Heijmen
authors.forename: Dominique A
authors.initials: DA
authors.lastname: Monserez
authors.forename: Sarah O S
authors.initials: SO
authors.lastname: Osman
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D054893:Cone-Beam Computed Tomography; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D016634:Radiosurgery; D011880:Radiotherapy Planning, Computer-Assisted; D061089:Radiotherapy, Image-Guided; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D014827:Vocal Cords / Q000528:radiation effects*