Evaluation of 63 patients undergoing primary radiation therapy for tre
atment of T1 and T2 glottic carcinomas was undertaken to evaluate the
success of primary treatment and to identify factors which might influ
ence recurrence or voice quality. Twelve patients (19%) recurred follo
wing radiation therapy, with ultimate salvage in 11, for a 3-year surv
ival rate of 98%. Voice preservation was achieved in 83%. Continued sm
oking after radiation therapy was associated with significantly greate
r risk of recurrence. Stage of tumor and anterior commissure involveme
nt were not associated with increased recurrences. Sixty-seven percent
of patients who did not recur had good voice quality after treatment.
Vocal fold stripping or excisional biopsy rather than limited biopsy
for initial diagnosis, complications of treatment, and continued smoki
ng after treatment were all significantly associated with an increased
risk of poorer voice quality after treatment while bilateral vocal fo
ld tumors were associated with risks that approached significance. Voi
ce analysis of five patients revealed that objective changes in voice
can be detected after radiation therapy in those with associated risk
factors but may be normal in those without these risk factors.