Definitive radiotherapy for early (T1-T2) Glottic Squamous cell carcinoma: a 20 year Cleveland clinic experience

• Type of Material: Article
• Authors: Mohammad Khan, Emory University; Shlomo A. Koyfman, Cleveland Clinic; Grant K. Hunter, Cleveland Clinic; Chandana A. Reddy, Cleveland Clinic; Jerrold P. Saxton, Cleveland Clinic
• Language: English
• Date: 2012-11-19
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2012 Khan et al.; licensee BioMed Central Ltd.
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://dx.doi.org/10.1186/1748-717X-7-193
• Title of Journal or Parent Work: Radiation Oncology
• ISSN: 1748-717X
• Volume: 7
• Issue: 1
• Start Page: 193
• End Page: 193
• Keywords: Life Sciences & Biomedicine; OUTCOMES; ONCOLOGY; RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING; LOCAL-CONTROL; SURVIVAL; Glottic carcinoma; T1; RADIATION; Larynx; Oncology; EXTERNAL-BEAM RADIOTHERAPY; PRETREATMENT HEMOGLOBIN; Science & Technology; Outcome; Carcinoma; Radiology, Nuclear Medicine & Medical Imaging; CANCER; Radiotherapy; Squamous cell
• Research Categories: Health Sciences, Oncology

Abstract

Purpose: To report our 20 yr experience of definitive radiotherapy for early glottic squamous cell carcinoma (SCC). Methods and materials: Radiation records of 141 patients were retrospectively evaluated for patient, tumor, and treatment characteristics. Cox proportional hazard models were used to perform univariate (UVA) and multivariate analyses (MVA). Cause specific survival (CSS) and overall survival (OS) were plotted using cumulative incidence and Kaplan-Meir curves, respectively. Results: Of the 91% patients that presented with impaired voice, 73% noted significant improvement. Chronic laryngeal edema and dysphagia were noted in 18% and 7%, respectively. The five year LC was 94% (T1a), 83% (T1b), 87% (T2a), 65% (T2b); the ten year LC was 89% (T1a), 83% (T1b), 87% (T2a), and 53% (T2b). The cumulative incidence of death due to larynx cancer at 10 yrs was 5.5%, respectively. On MVA, T-stage, heavy alcohol consumption during treatment, and used of weighted fields were predictive for poor outcome (p < 0.05). The five year CSS and OS was 95.9% and 76.8%, respectively. Conclusions: Definitive radiotherapy provides excellent LC and CSS for early glottis carcinoma, with excellent voice preservation and minimal long term toxicity. Alternative management strategies should be pursued for T2b glottis carcinomas.