RADIATION TREATMENT OF GLOTTIC SQUAMOUS-CELL CARCINOMA, STAGE-I AND STAGE-II - ANALYSIS OF FACTORS AFFECTING PROGNOSIS

Purpose: At least in some European Countries, there is still considera ble controversy regarding the choice between surgery and radiotherapy for the treatment of patients with early laryngeal-glottic carcinoma, Methods and Materials: Two hundred and forty-six patients with larynge al-glottic neoplasms, Stage I-II, were treated with radical radiothera py, Before radiotherapy the patients were evaluated to determine the s urgical procedure of choice. Either 66-68.4 Gy (33-38 fractions) or 63 -65 Gy (28-29 fractions) of radiation therapy (RT) were administered, The overall disease free survival was determined for each subgroup of patients, Univariate and multivariate analyses were performed to deter mine significant prognostic variables, Results: Five-and 10-year overa ll survival rates mere 83 and 72%, respectively, At a median follow-up of 6 gears 204 patients are alive and disease free, No patient develo ped distant metastases. One patient died of a large local recurrence, 38 patients died of causes unrelated to their tumor, and 3 patients we re lost to follow-up, The multivariate analysis confirmed that perform ance status (PS), macroscopic presentation of the lesion, and persiste nce of dysphonia after radiotherapy are significant prognostic factors , Conclusions: According to the multivariate analysis, the patients wi th PS >80 and with exophytic lesions are eligible for radical RT, The surgical procedure proposed for each patient was not found to be an in dependent prognostic factor, (C) 1998 Elsevier Science Inc.