HAS RADIOTHERAPY BECOME TOO EXPENSIVE TO BE CONSIDERED A TREATMENT OPTION FOR EARLY GLOTTIC CANCER

Background. External beam radiotherapy and surgery produce equivalent long-term survival and tumor control in early glottic cancer. The expe nse and cost of radiotherapy have been challenged. Methods. A retrospe ctive review was performed for 57 patients undergoing radiotherapy for glottic cancer. End points included local tumor control, relapse-free survival, cause-specific survival, medical charges, and costs. The re sults were compared with those of 265 patients who underwent transoral endoscopic removal or an open laryngeal procedure at the same institu tion. Results. The local control, larynx preservation, re-treatment, v oice quality, relapse-free survival, and cancer death results and medi cal charges and costs are reported by treatment. Conclusions. Radiothe rapy provides at least equivalent, if not superior, local tumor contro l, larynx preservation, voice quality, and survival, compared with the surgical options. Overall medical charges and costs for radiotherapy are similar to transoral endoscopic resection and less than partial ve rtical laryngectomy. (C) 1997 John Wiley & Sons, Inc.