title: Exclusive Radiotherapy for Early-stage Glottic Cancer: A Single-institution Retrospective Analysis with a Focus on Voice Quality.
abstract: OBJECTIVE
  To report on clinical outcomes of patients with early-stage glottic cancer treated with exclusive radiotherapy with specific analysis of voice quality.
  
  
  METHODS
  A consecutive cohort of 55 patients with early glottic cancer was retrospectively analyzed. Patients were treated with exclusive radiation up to a conventionally fractionated total dose of 66-70 Gy with a 3-dimensional conformal technique. Oncological outcomes and toxicity profiles were investigated. A sub-sample of this cohort was also analyzed in terms of voice quality employing subjective and objective tools such as the Voice Handicap Index-10 (VHI-10) and the Multidimensional Voice Program (MDVP™) software and was compared to a group of similar patients treated with CO2 laser cordectomy.
  
  
  RESULTS
  after a median observation time of 74.5 months, 5- and 10-year local control was 89% [95% confidence interval (CI)=70.7-93.1%] and 86% (95% CI=68.7-89.6%), respectively. Larynx-preservation rate was 91.8% (95% CI=82.4%-94.9%) at 10 years. Five- and 10-year actuarial overall survival was 72% (95% CI=50.4-79.2%) and 56% (95% CI=48.7-64.3%). Maximum detected acute toxicity included G3 dermatitis (5.4%) and G4 dyspnea (1.8%). Late toxicity profile was mild. VHI-10 scores showed a mild voice disability in both groups, with no statistically significant difference (p=0.12), even when investigating different domains. Patients treated with radiation had a lower deterioration rate in all parameters excluding low voice, interruptions of sound and diplophony.
  
  
  CONCLUSIONS
  Exclusive radiation proved an effective treatment for patients with early glottic cancer in terms of both oncological outcome and voice quality.
authors.affiliation: Department of Oncology-Radiation Oncology, University of Turin School of Medicine, Turin, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Potenza
authors.affiliation: Department of Oncology-Radiation Oncology, University of Turin School of Medicine, Turin, Italy pierfrancesco.franco@unito.it.
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Franco
authors.affiliation: Department of Oncology-Radiation Oncology, University of Turin School of Medicine, Turin, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Moretto
authors.affiliation: Department of Oncology-Radiation Oncology, University of Turin School of Medicine, Turin, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Badellino
authors.affiliation: Department of Oncology-Radiation Oncology, University of Turin School of Medicine, Turin, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Balcet
authors.affiliation: Radiotherapy Department, AOU City of Health and Science, Turin, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Department of Surgical Sciences-First ENT Division, University of Turin School of Medicine, Turin, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Landolfo
authors.affiliation: Department of Surgical Sciences-First ENT Division, University of Turin School of Medicine, Turin, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Riva
authors.affiliation: Department of Surgical Sciences-First ENT Division, University of Turin School of Medicine, Turin, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pecorari
authors.affiliation: Department of Oncology-Radiation Oncology, University of Turin School of Medicine, Turin, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ragona
authors.affiliation: Radiotherapy Department, AOU City of Health and Science, Turin, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Rampino
authors.affiliation: Department of Oncology-Radiation Oncology, University of Turin School of Medicine, Turin, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D005260:Female; D005931:Glottis / Q000528:radiation effects*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014833:Voice Quality / Q000528:radiation effects*
keywords: Glottic cancer; radiotherapy; voice quality