DEFINITIVE RADIOTHERAPY FOR EARLY GLOTTIC CARCINOMA - PROGNOSTIC FACTORS AND IMPLICATIONS FOR TREATMENT

Purpose: Treatment and disease-related factors were analyzed for their influence on the outcome of patients treated definitively with irradi ation (RT) for early glottic carcinoma. Methods and Materials: One hun dred two patients with stage T1 or T2 glottic carcinomas were treated definitively with RT from December 1983 through September 1993. Median follow-up time was 63 months. Factors analyzed for each patient inclu ded age, sex, stage, anterior commissure involvement, surgical alterna tive, histologic differentiation, held size, total dose, fraction size , and total treatment time. Survival analysis methods were employed to assess the effects of these factors on local control and complication rates. Results: The 5-year local control rates by stage were as follo ws: T1a, 92%; T1b, 80%; T2a, 94%; and T2b, 23%. By univariate analysis , factors found to have a significant impact on local control were sta ge, surgical alternative, fraction size, anterior commissure involveme nt, and overall treatment time. By multivariate analysis, stage, held size, and fraction size were the only significant factors that indepen dently influenced local control. Conclusions: The inferior control rat e for stage T2b lesions has implications for treatment. Our study supp orts the conclusions of reports in the literature showing that low fra ction size negatively influences outcome in patients with early glotti c cancer. (C) 1997 Elsevier Science Inc.