Impaired vocal cord mobility in T2N0 glottic carcinoma: Suboptimal local control with Radiation alone.
T2 glottic cancer with impaired vocal cord mobility (T2b) is known to have higher local failure rates when compared with T2 cancers without impaired cord mobility (T2a) treated with radiotherapy (RT) alone.



In this retrospective review, we identified and compared the local control rates of 3 groups: T2aN0 treated with RT; T2bN0 treated with RT; and T2b-3N0-2 treated with chemoradiotherapy (CRT).



The 3-year local control rate was 95.1% for T2aN0, 73.2% for T2bN0 treated with RT, and 91.5% for the CRT group (p = .01). On univariate analysis, T2bN0 disease versus T2aN0 treated with RT alone (p = .03) was significantly associated with inferior local control.



Patients with glottic cancer with impaired vocal cord mobility (T2b) have a high rate of local failure with RT alone. The addition of concurrent chemotherapy should be considered for patients highly motivated toward larynx preservation and willing to accept the potential toxicity. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1832-1836, 2016.
Department of Medicine, Seidman Cancer Center, University Hospitals, Case Medical Center, Cleveland, Ohio.
Priyanka
P
Bhateja
Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
Matthew C
MC
Ward
Department of Radiation Oncology, Intermountain Healthcare, Murray, Utah.
Grant H
GH
Hunter
Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
John F
JF
Greskovich
Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
Chandana A
CA
Reddy
Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio.
Tobenna I
TI
Nwizu
Department of Otolaryngology, Cleveland Clinic, Cleveland, Ohio.
Eric
E
Lamarre
Department of Otolaryngology, Cleveland Clinic, Cleveland, Ohio.
Brian B
BB
Burkey
Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio.
David J
DJ
Adelstein
Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
Shlomo A
SA
Koyfman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D059248:Chemoradiotherapy / Q000379:methods; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000401:mortality / Q000473:pathology* / Q000628:therapy*
T2; chemotherapy; glottis cancer; impaired mobility; radiotherapy