Carcinoma-in-situ of the glottic larynx: Results of treatment with radiation therapy

Purpose: Carcinoma-in-situ (CIS) of the vocal cords frequently progresses t o invasive disease if untreated. Treatment approaches include vocal cord st ripping, radiation therapy (RT), and laser excision, The purpose of this an alysis was to assess the efficacy and safety of a standard RT regimen in th e treatment of this condition. Methods and Materials: Between January 1980 and December 1994, 67 patients (52 men, 15 women; median age, 65 years) with glottic CIS were treated with RT. The standard RT regimen was 51 Gy in 20 fractions given over 4 weeks ( 99% of patients). Prior to receiving RT, 21 patients (31%) had undergone 1 or 2 vocal cord stripping procedures, and 1 had been treated with laser, Results: With a median follow-up of 6.5 years, 1 patient developed invasive glottic cancer, giving a 5-year actuarial local control rate of 98%, This patient recurred 14 months after treatment and was salvaged with laryngecto my, He is currently free of disease 2 years after surgery. There were no se rious acute or late treatment complications. Sixteen patients (24%) develop ed subsequent malignancies, 8 of these being in the upper aerodigestive tra ct, although none were in the radiation field. Conclusions: Moderate-dose radiation therapy is an effective treatment for glottic CIS. It is well tolerated, produces no serious acute or long-term s ide effects, with an excellent cure rate. (C) 2001 Elsevier Science Inc.