E. Medini et al., CURATIVE RADIOTHERAPY FOR STAGE II-III SQUAMOUS-CELL CARCINOMA OF THEGLOTTIC LARYNX, American journal of clinical oncology, 21(3), 1998, pp. 302-305
The authors report the analysis and outcome of curative radiotherapy f
or stage II, and III squamous cell carcinoma of the glottic larynx. Th
irty-nine men with invasive, previously untreated squamous cell carcin
oma of the glottic larynx were referred for curative radiotherapy from
May 1976 through June 1991, to the Veterans Administration Medical Ce
nter in Minneapolis, Minnesota, U.S.A. Thirty-eight patients had T2NO
disease, and one had T2N1 disease. All patients were treated by megavo
ltage units (two by cobalt 60 and 37 by 4 mV-linear accelerator). The
median fractional dose was 1.80 Gy, and the median total tumour dose w
as 70.20 Gy. Surgical salvage was reserved for irradiation failure. Al
l patients had a minimum 5-year follow-up. The Kaplan-Meier method was
used for survival analysis. The 5-year disease-free survival with voi
ce preservation after radiotherapy was 70.2% (80% for T2a and 64% for
T2b patients). The ultimate 5-year disease-free survival for all T2 pa
tients after surgical salvage was 91%. In nine patients, ten second pr
imary malignancies were diagnosed during follow-up. Nine of these seco
nd lesions occurred in the aerodigestive tract. Curative radiotherapy
using conventional fractionation regimen with surgical salvage for irr
adiation failure is an efficacious modality for T2NO and T2N1 squamous
cell carcinoma of the glottic larynx. A high incidence of second mali
gnancy was noted in our series.