Abstract
Purpose The aim was to evaluate the treatment outcomes and prognostic characteristics of patients with early-stage glottic laryngeal carcinoma who underwent radical radiotherapy (RT) with different techniques. Patients and Methods Radiotherapy was applied using the 2D conventional technique between 1991 and 2004 (130 patients), 3DCRT until 2014 (125 patients), and by VMAT until January 2017 (44 patients). Clinical T stages were 38 (12.7%) for Tis, 209 (69.9%) for T1, and 52 (17.4%) for T2. Radiotherapy technique and energy, anterior commissure involvement, and stage were analyzed as prognostic factors. Results The median total dose was 66 (50–70) Gy, and median follow-up time was 72 (3–288) months; 5-year disease-specific survival (DSS) rates were 95.8%, 95.5%, and 88.6%, respectively, in Tis, T1, and T2 stages. In multivariate analyses, anterior commissure involvement was found significant for all survival and local control rates. The patients treated with VMAT technique had better local control and DSS rates. However, these results were not statistically significant. Conclusion In early-stage laryngeal carcinomas, radical RT is a function sparing and effective treatment modality, regardless of treatment techniques.
Highlights
T1–T2 N0 glottic laryngeal carcinomas can be treated with transoral laser excision (LS), open partial laryngectomy (PL), or radiotherapy (RT) [1]
We evaluated the treatment outcomes and the prognostic factors of patients with early-stage glottic laryngeal carcinoma
One-hundred thirty (43.5%) patients were treated with the conventional technique, 125 (41.8%) cases were treated with 3DCRT, and 44 of them were treated with (14.7%) VMAT
Summary
T1–T2 N0 glottic laryngeal carcinomas can be treated with transoral laser excision (LS), open partial laryngectomy (PL), or radiotherapy (RT) [1]. In comparison with transoral laser surgery and RT, a significant difference in disease control and voice quality especially in T1a patients has not been described [1,2,3,4,5]. The data in T1b cases are limited, local control rates are better with RT [1, 4, 6]. In a more disseminated disease like T1b, a better local control over LS can be achieved with RT [4, 6, 7]. Five years of local control rates are 85–94% for T1 glottic cancers and 70–85% for T2 with radical RT in the literature [5, 7,8,9,10,11]. According to SEER data, majority of the patients die due to secondary cancers or nonmalignant diseases like cerebrovascular attack [13, 14]
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