Treatment results of radical radiation therapy for early glottic carcinoma

ABSTRACT

To evaluate the effect of host; tumour and treatment-related parameters that might influence the local control; of early squamous cell carcinoma of the glottis treated with radiotherapy. Seventy patients with T1-T2 NOMO squamous cell carcinoma of the glottic larynx were retrospectively analyzed with a minimum 2-years follow-up. All patients were treated daily with telecobalt unit at 2 GY per fraction to doses of 60-70 GY [median 64]. The following factors were analyzed through uni and multivariate analysis; age sex; smoking histologic type and grade; T-extent; anterior commissure invovement field size total dose given overall treatment time and salvagve therapy. The initial treatment response [CR] were 97.8% and 76% while the 5-year local control rates were 82.2% and 56% for T1 and T2 lesions, respectively. On univariate analysis, the recieved total dose was a significant factor for both initial response and local control. Initial response and local control for T1 lesions were 100% and 90%, if total dose given > 60 GY. The corresponding values for T2 lesions were 79% and 63% [P< 0.0001;< 0.001 for T1 and > 0.05 for T2]. Better response and control rates were seen among T1 and T2 patients completed their therapy within affect success of radiotherapy significantly. The effect of salvage therapy was significan on improving the local control, mainly on T1b and T2b [P < 0.01]. On multivariate analysis, the most significant predictor factors for 5-year local control were the total dose salvage therapy and initial treatment response. The 3; 5; and 10-year actuarial survival and local control were better among T1 than T2 lesions. Speech preserved was of good quality in 87% and 55% of patients with T1 and T2 lesion. Radiation therapy is te treatment of choice that gives excellent response and local control in T1 glottic cancer with a good preseved speech if treated by 66 GY within treatment [CT] to assess the extent of vocal cord lesion; ENT examination at dose 40 GY for better assessement of response; and the necessary increase in the total dose and dose per fraction, salvage therapy is kept for radiation failures