title: Transoral surgery vs intensity-modulated radiotherapy for early supraglottic cancer: a systematic review.
abstract: OBJECTIVE
  To provide clinicians with a critical review of outcomes for endolaryngeal surgery and intensity-modulated radiation therapy (IMRT) for early-stage supraglottic cancer.
  
  
  RESULTS
  A total of 971 potential articles were reviewed, with inclusion of 14 studies comparing IMRT with transoral surgery. One study analyzed IMRT, one transoral robotic surgery, and the remaining were transoral laser microsurgery studies. A weighted average and 95% confidence interval of all surgery patients showed a local control of 90.36 ± 1.14% (n = 118) for T1 lesions, 83.09 ± 1.36% (n = 232) for T2 lesions, and 86.38 ± 0.82% (n = 429) overall. The one study examining IMRT outcomes reported a local control of 70 ± 10.07% and overall survival of 63% over 5 years for T2 lesions (n = 78), with no reported T1 data or secondary outcomes.
  
  
  CONCLUSIONS
  Endolaryngeal surgery as definitive therapy for T1 and T2 supraglottic cancer has excellent local control. Although endolaryngeal surgery performed better than IMRT, the data are limited, and a definitive comparison with surgery cannot be made. Additional studies are required.
authors.affiliation: aDepartment of Otolaryngology - Head and Neck Surgery bKeck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Swanson
authors.forename: Garren
authors.initials: G
authors.lastname: Low
authors.forename: Uttam K
authors.initials: UK
authors.lastname: Sinha
authors.forename: Niels
authors.initials: N
authors.lastname: Kokot
mesh_terms: D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008866:Microsurgery / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome