Radiotherapy Results of Stage I Glottic Cancer

Kim, Jae Chul; Park, In Kyu

Abstract

PURPOSE: This study was to evaluate survival, failure patterns, and prognostic factors of stage I squamous cell carcinoma of the glottic larynx after curative radiation therapy.
MATERIALS AND METHODS
A retrospective analysis was done for 57 patients with glottic cancer who were treated with curative radiation therapy from June 1985 to November 1992. There were 55 male and two female patients. Patients' age ranged from 17 to 71 years (median 39 years). Radiation therapy was delivered five times a week, 2 Gy daily, total 66 Gy using 6 MV X- ray.
RESULTS
Complete response (CR) was noted in 51 out of 57 patients (89.5%) and persistent disease (PER) in six out of 57 patients (10.5%). The disease-free survival rates at 3 and 5 years were 72.9% and 63.8%, respectively. Seven failures were observed among 51 CR patients during follow-up. Salvage total laryngectomy for six recurred patients and partial laryngectomy for one recurred patient were done with successful results, i.e., all of them were actually salvaged. Among six PER patients, salvage total laryngectomy for two patients and partial laryngectomy for two patients were done and two patients refused operation. Following salvage surgery for the four PER patients, three were salvaged and one failed locoregionally. Among the 13 failures 10 (76.9%) were salvaged with surgery. The ultimate local control rate at 5 years was 92.3% and overall 47 out of 57 (82.5%) patients were able to preserve their larynx. The 5-year disease-free survival rates were 85.5% for posterior lesions, and 61.6% for anterior lesions (p<0.05). Cord mobility, involvement of anterior commissure, field size, and T stage did not impact on disease-free survival.
CONCLUSION
Considering the high percentage of voice preservation with initial radiotherapy, radiotherapy should be the first choice in the treatment of stage I glottic carcinoma.