Curative radiotherapy for T1-2 glottic larynx carcinoma

This is an analysis of 87 patients (85 males, 2 females; age range 38 to 81 years, with an average of 63 years) with T1-2N0 squamous cell carcinoma of the glottic larynx curatively treated with radiotherapy between 1990 and 1997 at our department. Of these 87 patients, 24 patients had T1a lesions, 19 had T1b lesions, and 44 had T2 lesions. Most patients received a total 60 to 70 Gy of radiation, with a fraction dose of 2 Gy. Chemotherapy with low-dose CDDP was combined in 7 cases with T2 lesions. The 5-year local control rates for all, T1a, T1b, and T2 were 61%, 82%, 60%, and 51%, respectively. The local control for T1 was significantly better than that for T2. Among all evaluated treatment factors, a higher prescribed total dose was the only significantly unfavorable prognostic factor for local control, 70% at 5 years for cases receiving less than 65 Gy of irradiation, and 48% for 65 Gy or more. This is considered due to the trend that a higher dose was often prescribed for cases with T2 lesions or for tumors that responded poorly to radiotherapy. The other treatment factors, such as beam energy, beam arrangement, wedge filter, compensating bolus, overall treatment time, treatment delay, and field size, were not significantly related to local control. For the sake of treatment outcome improvement, we increased the total dose to 66-70 Gy for T1 lesions, and to 70 Gy combined with low-dose CDDP administration for T2 lesions. (author)