In the current study, excellent outcome with good quality of life and voice handicap index scores were reported. T2 tumours, in particular T2b, and continuing smoking after radiotherapy correlated significantly with poor local control and worse voice handicap index.

Compared to radiotherapy alone, chemoradiation significantly improved functional outcome, increased acute toxicity, but without significant increase in late radiation-induced side effects. Statistically significant deterioration in QoL scores was reported only for xerostomia. IMRT, compared to 3DCRT, reduced the incidence and severity of acute and late toxicity, thereby broadening the therapeutic window, and may allow dose escalation for further improvement of outcomes of laryngeal preservation protocols.

Upfront neck dissection followed by (chemo)radiation did not negatively impact on oncologic outcomes, toxicity, or quality of life and therefore is to be regarded as a safe and effective treatment option for small HPC with bulky nodal disease, especially in busy radiation departments with unacceptably long waiting time for definitive (chemo)radiation.

The objective of the presented study is to report on retrospectively collected data on long-term outcome and toxicity and prospective assessment of quality of life (QoL) and Voice-Handicap Index (VHI) of patients with T1a glottic cancer treated with radiotherapy. Between 1985 and 2011, 549 patients were treated. Endpoints were local control (LC), toxicity, QoL and VHI. After a median follow-up of 93 months, the actuarial rates of LC were 91, and 90 % at 5- and 10-years, respectively. Continuing smoking (p < 0.001) and anaemia (p = 0.02) were significantly correlated with poor LC on univariate analysis and fractionation schedule did not show significant correlation (p = 0.08). On multivariate analysis, only continuing smoking retained significance (p = 0.001). These patients had also significantly increased incidence of second primary tumour and lower overall survival rates. The incidence of grade ≥2 late xerostomia and dysphagia were 10 and 6 %, respectively. Slight and temporary deterioration of QoL-scores was reported. The scores on the EROTC-QOL-H&N35 dysphagia and xerostomia at 24 months were -2 and -3, compared to baseline, respectively. VHI improved significantly from 34 at baseline to 21 at 24 months. Patients who continued smoking had significantly worse VHI. In conclusion, excellent outcome with good QoL and VHI were reported. Patients who continued smoking after radiotherapy had significantly poor LC and worse VHI. The current study emphasizes the importance of smoking cessation and the non-inferiority of hypofractionated schemes in terms of outcome and VHI. At our institution, phase II study is going to evaluate the role of single vocal cord irradiation with high fraction dose.

These data support the use of concurrent chemoradiotherapy as an effective alternative to primary ultra-radical surgery to treat LAVC with an acceptable toxicity profile.