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,vith stage TI 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, ses, stage, anterior commissure involvement, surgical alterna tive, histologic differentiation, field size, total dose, fraction siz e, and total treatment time. Survival analysis methods mere employed t o assess the effects of these factors on local control and complicatio n rates. Results: The 5-year local control rates by stage were as foll ows: Tla, 92%; T1b, 80%; T2a, 94%; and T2b, 23%. By univariate analysi s, factors found to have a significant impact on local control were st age, surgical alternative, fraction size, anterior commissure involvem ent, and overall treatment time. By multivariate analysis, stage, fiel d size, and fraction size were the only significant factors that indep endently influenced local control. Conclusion: The inferior control ra te for stage T2b lesions has implications for treatment. Our study sup ports the conclusion 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.