VALUE OF LARYNGEAL CARTILAGE SCLEROSIS AS A PREDICTOR OF OUTCOME IN PATIENTS WITH STAGE T3 GLOTTIC CANCER TREATED WITH RADIATION-THERAPY

PURPOSE: To determine whether sclerosis of the laryngeal cartilages wa s a predictor of a poor outcome in patients with stage T3 glottic canc er treated with radiation therapy. MATERIALS AND METHODS: Thirty-three patients with stage T3 glottic cancer underwent computed tomography ( CT) before radiation therapy. Twenty-two patients underwent posttreatm ent CT. The presence of cartilage sclerosis, cartilage erosion, marrow invasion, and cartilage necrosis was determined. RESULTS: Nineteen of the 33 patients had cartilage sclerosis at CT. Seventeen patients had sclerosis of a single laryngeal cartilage (14 arytenoid, two cricoid, and one thyroid), and two had sclerosis of adjacent laryngeal cartila ges (arytenoid and cricoid in both cases). Of the 17 patients with iso lated laryngeal cartilage sclerosis, disease was controlled with radia tion therapy alone in 15 and with salvage laryngectomy in two. Both pa tients with cricoid and arytenoid sclerosis died of their original can cer despite undergoing early salvage laryngectomy. Of the 14 patients without sclerosis, eight had no evidence of disease, two died of their disease, and four died of intercurrent disease. CONCLUSION: T3 glotti c cancer with isolated laryngeal cartilage sclerosis can be cured with radiation therapy.