Radiation treatment of glottic squamous cell carcinoma, stage I and II: Analysis of factors affecting prognosis

Purpose: At least in some European Countries, there is still considerable controversy regarding the choice between surgery and radiotherapy for the treatment of patients with early laryngeal-glottic carcinoma, Methods and Materials: Two hundred and forty-six patients with laryngeal-glottic neoplasms, Stage I-II, were treated with radical radiotherapy, Before radiotherapy the patients were evaluated to determine the surgical procedure of choice. Either 66-68.4 Gy (33-38 fractions) or 63-65 Gy (28-29 fractions) of radiation therapy (RT) were administered, The overall disease free survival was determined for each subgroup of patients, Univariate and multivariate analyses were performed to determine significant prognostic variables, Results: Five-and 10-year overall survival rates mere 83 and 72%, respectively, At a median follow-up of 6 gears 204 patients are alive and disease free, No patient developed distant metastases. One patient died of a large local recurrence, 38 patients died of causes unrelated to their tumor, and 3 patients were lost to follow-up, The multivariate analysis confirmed that performance status (PS), macroscopic presentation of the lesion, and persistence of dysphonia after radiotherapy are significant prognostic factors, Conclusions: According to the multivariate analysis, the patients with PS >80 and with exophytic lesions are eligible for radical RT, The surgical procedure proposed for each patient was not found to be an independent prognostic factor, (C) 1998 Elsevier Science Inc.