Abstract
PurposePresentation of long-term results of radiation treatment in patients with T1 glottic cancer and evaluation of prognostic factors.MethodsWe performed a retrospective analysis in a group of 569 patients with T1 squamous cell glottic carcinoma treated with radiotherapy at the Center of Oncology in Cracow between 1977 and 2007. In all, 503 (88%) patients presented with T1a stage disease and 66 (12%) with T1b. Anterior commissure infiltration was present in 179 (31%) patients. Average hemoglobin level prior to therapy was 13.9 g/dl. Using the body mass index (BMI), 114 (20%) patients were underweight, and 91 (16%) were overweight. Median time between collecting tumor specimen and beginning of radiotherapy was 56 days (range 14–145 days). Treatment regimen was normofractionated with single fraction ≤2 Gy in 102 (18%) and hypofractionated in 467 (82%) patients.ResultsThe 5‑ and 10-year overall survival (OS), disease-specific survival (DSS) and local control (LC) rates were 85 and 68%, 88 and 86%, 89 and 87%, respectively. Multivariate analysis showed that tobacco smoking, low hemoglobin level (<13 g/dl), anterior commissure infiltration, fraction dose ≤2 Gy and time from collecting specimen to beginning of therapy longer than 30 days had negative impact on LC and DSS. Patients’ age over 60 years, worse performance status and malnutrition (BMI <18.5) had negative impacts on OS.ConclusionsRadiotherapy is a highly effective treatment method in patients with T1N0M0 glottic cancer. LC and DSS may be improved following hypofractionation, smoking cessation, and shortening of waiting-time until start of treatment. OS was mainly influenced by nutritional and performance status.
Highlights
Laryngeal cancer is the most common malignancy of the head and neck region and constitutes 2–4% of all malignant neoplasms
The 5-year local control for radiotherapy ranges from 80–95%, and from 82–100% for transoral laser surgery [4, 8,9,10,11,12,13,14,15]
In the remaining group of 33 patients, laryngeal cancer was the cause of death in 21 (4%) cases, and 12 patients (2%) died because of second malignancy—lung cancer
Summary
Laryngeal cancer is the most common malignancy of the head and neck region and constitutes 2–4% of all malignant neoplasms. There are two efficient treatment methods for patients with T1 laryngeal cancer—radiotherapy and surgery (performed transorally with a laser). The 5-year local control for radiotherapy ranges from 80–95%, and from 82–100% for transoral laser surgery [4, 8,9,10,11,12,13,14,15]. The treatment method is selected based mainly on institutional experience and the patient’s preferences. Radiotherapy is preferred due to better voice quality after treatment [16, 17]. The basic goal of therapy is to give a patient the highest chance of cure, as well as minimize the risk of side effects and ensure the best possible functional result
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