title: Long-Term Outcome of Definitive Radiotherapy for Early Glottic Cancer: Prognostic Factors and Patterns of Local Failure.
abstract: OBJECTIVE
  This study evaluates the long-term results of definitive radiotherapy (RT) for early glottic cancer. Clinical and treatment factors related to local control and patterns of failure are analyzed.
  
  
  METHODS
  We retrospectively reviewed 222 patients with T1-2N0 squamous cell carcinoma of the glottic larynx treated with definitive RT from 1981 to 2010. None of the patients received elective nodal RT or combined chemotherapy. The median total RT dose was 66 Gy. The daily fraction size was < 2.5 Gy in 69% and 2.5 Gy in 31% of patients. The RT field extended from the hyoid bone to the cricoid cartilage.
  
  
  RESULTS
  The median age was 60 years, and 155 patients (70%) had T1 disease. The 5-year rates of local recurrence-free survival (LRFS) and ultimate LRFS with voice preservation were 87.8% and 90.3%, respectively. T2 (hazard ratio [HR], 2.30; 95% confidence interval [CI], 1.08 to 4.94) and anterior commissural involvement (HR, 3.37; 95% CI, 1.62 to 7.02) were significant prognostic factors for LRFS. In 34 patients with local recurrence, tumors recurred in the ipsilateral vocal cord in 28 patients. There were no contralateral vocal cord recurrences. Most acute complications included grade 1-2 dysphagia and/or hoarseness. There was no grade 3 or greater chronic toxicity.
  
  
  CONCLUSIONS
  Definitive RT achieved a high cure rate, voice preservation, and tolerable toxicity in early glottic cancer. T2 stage and anterior commissural involvement were prognostic factors for local control. Further optimization of the RT method is needed to reduce the risk of ipsilateral tumor recurrence.
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors: Yu Jin
authors: YJ
authors: Lim
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.|Cancer Research Institution, Seoul National University College of Medicine, Seoul, Korea.|Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
authors: Hong-Gyun
authors: HG
authors: Wu
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Tack-Kyun
authors: TK
authors: Kwon
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: J Hun
authors: JH
authors: Hah
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Myung-Whun
authors: MW
authors: Sung
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Kwang Hyun
authors: KH
authors: Kim
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors: Charn Il
authors: CI
authors: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005931:Glottis / Q000473:pathology / Q000528:radiation effects*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy
keywords: Glottis; Laryngeal neoplasms; Local neoplasm recurrence; Radiation therapy; Risk factors; Squamous cell carcinoma