RADIOTHERAPY FOR T1 CARCINOMA OF THE GLOTTIS

Aims and background: The management of patients with T1 carcinoma of t he glottic larynx is controversial, because surgery and radiation ther apy are reported to be effective treatments, Several studies have show n radiotherapy to be safe and effective, with a high percentage of voi ce preservation and minimal complications, but most Italian physicians prefer to surgically treat such patients, Methods: From 1980 to 1990, 36 patients with stage I squamous cell glottic carcinoma were treated with radiotherapy alone at the Institute of Radiology of University o f Rome ''La Sapienza'', In all patients the irradiation fields were li mited to the larynx, with field size ranging from 4 x 4 cm to 7 x 7 cm , Total tumor doses ranged between 51 and 70 Gy (median 60 Gy) with a mean number of 30 fractions of 2 to 3 Gy per fraction (3 or 5 fraction s per week), Results: After a median follow-up of 98 months, we observ ed an overall survival rate at 5 years of 91.4% and actuarial 10-year survival of 85.7%, Local control was achieved in 97.1% of cases, with an event-free survival of 94.2% at 5 and 10 years, No major complicati ons like necrosis or persistent edema of the larynx were observed, Min or complications like dysphonia (8%) and dysphagia (5.5%) were tempora ry; laryngeal function was completely preserved at the end of therapy, Final voice quality ranged from good to excellent. Conclusions: Our s eries confirms that radiation therapy has a major role in the manageme nt of early glottic cancer, with results comparable to surgical approa ches and with better voice preservation.