RADIOTHERAPY FOR SQUAMOUS-CELL CARCINOMA OF THE SUPRAGLOTTIC LARYNX -AN ALTERNATIVE TO SURGERY

Background. The purpose of this article is to present the results of r adiotherapy with or without neck dissection for squamous cell carcinom a of the supraglottic larynx at the University of Florida and to compa re these data with those obtained after conservation surgery. Methods. Continuous-course radiotherapy alone or combined with a planned neck dissection was used to treat 209 patients with 211 supraglottic carcin omas between 1964 and 1992; all patients had follow-up for greater tha n or equal to 2 years. Results. The 5-year rates of local control afte r radiotherapy were as follows: T1, 100%; T2, 83%; T3, 68%; and T4, 56 %. Tumor volume, as calculated on pretreatment computed tomography (CT ) scan, and vocal cord mobility influenced the likelihood of local con trol. Conclusions. Based on our data and the literature, early or mode rately advanced supraglottic carcinomas may be treated successfully wi th either supraglottic laryngectomy or radiotherapy. Supraglottic lary ngectomy probably produces a higher initial local control rate but, ba sed on anatomic and coexisting medical constraints, is suitable for a smaller subset of patients and has a higher risk of complications comp ared with radiotherapy. (C) 1996 John Wiley & Sons, Inc.