title: Definitive radiotherapy for early (T1-T2) glottic squamous cell carcinoma: a 20 year Cleveland Clinic experience.
abstract: OBJECTIVE
  To report our 20 yr experience of definitive radiotherapy for early glottic squamous cell carcinoma (SCC).
  
  
  METHODS
  Radiation records of 141 patients were retrospectively evaluated for patient, tumor, and treatment characteristics. Cox proportional hazard models were used to perform univariate (UVA) and multivariate analyses (MVA). Cause specific survival (CSS) and overall survival (OS) were plotted using cumulative incidence and Kaplan-Meir curves, respectively.
  
  
  RESULTS
  Of the 91% patients that presented with impaired voice, 73% noted significant improvement. Chronic laryngeal edema and dysphagia were noted in 18% and 7%, respectively. The five year LC was 94% (T1a), 83% (T1b), 87% (T2a), 65% (T2b); the ten year LC was 89% (T1a), 83% (T1b), 87% (T2a), and 53% (T2b). The cumulative incidence of death due to larynx cancer at 10 yrs was 5.5%, respectively. On MVA, T-stage, heavy alcohol consumption during treatment, and used of weighted fields were predictive for poor outcome (p < 0.05). The five year CSS and OS was 95.9% and 76.8%, respectively.
  
  
  CONCLUSIONS
  Definitive radiotherapy provides excellent LC and CSS for early glottis carcinoma, with excellent voice preservation and minimal long term toxicity. Alternative management strategies should be pursued for T2b glottis carcinomas.
authors.affiliation: Winship Cancer Center, Emory University, Atlanta, GA, USA. drkhurram2000@gmail.com
authors.forename: Mohammad K
authors.initials: MK
authors.lastname: Khan
authors.forename: Shlomo A
authors.initials: SA
authors.lastname: Koyfman
authors.forename: Grant K
authors.initials: GK
authors.lastname: Hunter
authors.forename: Chandana A
authors.initials: CA
authors.lastname: Reddy
authors.forename: Jerrold P
authors.initials: JP
authors.lastname: Saxton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary; D003680:Deglutition Disorders / Q000209:etiology; D055154:Dysphonia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate; D016896:Treatment Outcome; D014313:Trismus / Q000209:etiology