Prognostic factors of early glottic cancer treated with definitive radiotherapy

Objective: To analyze the prognostic factors of early glottic cancer (TINOMO) treated with radiotherapy alone. Methods: From 1958-1994, 238 patients (220 male) with TINOMO (UICC 1997) squamous cell carcinoma of the glottis were treated with radiotherapy alone through parallel opposing fields (median size, 22.5 cm2) to a median dose of 68 Gy over a median of 52 days. Loco-regional control (LC) and overall survival (OS) rates were estimated by the Kaplan-Meier method. Logrank and Cox regression analyses were used to identify the prognostic factors. Results: The median follow-up time was 127 months (range, 4-410 months). The 5- and 10- year OS rates were 84.0% and 74.9%. The 5-year LC rate was 82.2%. Forty-four patients developed recurrent disease (41 locally, 2 in cervical lymph nodes, 1 lost to follow-up); 23 had second malignancies. Unfavorable prognostic factors of LC were bulky tumor (P = 0.023), anterior commissura involvement (P = 0.024), and reduction of hemoglobin during treatment (P = 0.025). Conclusions: Radiotherapy alone provides good control for early glottic cancer. However, the negative prognostic factors for LC are bulky tumor, anterior commissura involvement and reduction of hemoglobin during treatment