title: Early glottic carcinoma treated by radiotherapy: defining a population for surgical salvage.
abstract: OBJECTIVE
  Not all patients with early Glottis squamous cell carcinoma will be cured by radiotherapy. This is an audit of a single center's experience with those patients who fail by this approach.
  
  
  METHODS
  This retrospective study was approved by the IRB (Institutional Review Board); eligibility criterion was patients treated between 1967 and December 2006, T(IS), T(1), T(2) N(0) SCC glottic carcinoma, with analysis occurring in 2009, and with a minimum follow-up of 2 years.
  
  
  METHODS
  The eligibility criteria for this ethics-approved study was that all patients started a course of radiotherapy for early glottic laryngeal SCC. Data included in the Larynx Cancer database includes information from the Radiation Oncology Department notes, referral letters, and follow-up information. This is categorized into patient, disease, and treatment factors.
  
  
  RESULTS
  Of 522 patients who commenced radiotherapy, local failure occurred in 105 patients; a salvage procedure was performed in 89, with surgery only in 83. For these 89 patients, the ultimate local control was 67%, with a larynx preservation procedure in 34%. Nodal failure occurred in 20 of the 522 patients (4%). There was a much higher failure rate in patients unfit for surgery (10/26-38%). Laryngectomy was the main salvage procedure in 55 patients.
  
  
  CONCLUSIONS
  Early recognition of local failure following radiotherapy for early glottic carcinoma may avoid laryngectomy as a salvage procedure.
authors.affiliation: Department of Radiation Oncology, The Prince of Wales Cancer Centre, Randwick, New South Wales, Australia.
authors.forename: Robert I
authors.initials: RI
authors.lastname: Smee
authors.forename: Janet R
authors.initials: JR
authors.lastname: Williams
authors.forename: Kathryn
authors.initials: K
authors.lastname: Broadley
authors.forename: G P
authors.initials: GP
authors.lastname: Bridger
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology* / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D017211:Treatment Failure