Survival and Prognostic Factors for Outcome after Radiotherapy for T2 Glottic Carcinoma

Abstract

Background: Local recurrence after radiotherapy for T2 glottic carcinoma remains an issue and identifying patients at risk for relapse is, therefore, important. This study aimed to assess the oncological outcomes and prognostic factors in a consecutive series of patients treated with radiotherapy for T2N0 glottic carcinoma. Methods: Patients with T2N0 glottic carcinoma treated with radiotherapy were included in this retrospective study. Five- and ten-year local control (LC), overall survival (OS), disease-specific survival (DSS), and laryngeal preservation (LP) rates were calculated with the Kaplan–Meier method. The impact of prognostic variables was evaluated with the log-rank test. Results: Ninety-four patients were included for analysis. LC, OS, DSS, and LP rates were 70.5, 63.7, 86.0, and 74.7%, respectively at five years and 65.8, 41.0, 75.6, and 72.4% at 10 years. In total, 46 scans were included in the analyses. Vertical involvement of the anterior commissure on imaging showed a significant impact on LC. Conclusions: In accordance with previously described surgical risk factors, we identified vertical involvement of the anterior commissure on imaging as a prognostic factor for radiation failure.

Oncological outcome of vocal cord-only radiotherapy for cT1-T2 glottic laryngeal squamous cell carcinoma

“…For patients with cT2 tumors, this was 77%. These oncological outcomes are comparable with historical series published [18][19][20][21][22][23]. A study from Chera et al included 585 patients treated in a single institution between 1964 and 2006 [20].…”

“…The majority was treated with Cobalt sources and parallel fields. A more recent study [ 19 ] from the Netherlands described oncological outcome of 94 cT2 glottic cancer patients treated with radiotherapy between 2000 and 2012. Local control rate in this study was comparable to the Italian series, with a local control rate at 5 years of 70.5%.…”

“…In the series from Elicin et al, there were 3/761 patients who underwent total laryngectomy because of laryngeal dysfunction of whom one was treated with hypofractionated radiotherapy and two conventionally fractionated radiotherapy [ 22 ]. In the series from Hendriksma et al, late toxicity was reported in 5.3%, of which 2 patients developed laryngeal necrosis [ 19 ]. The laryngectomy-free survival at 5 years in that series was lower (74.7%) compared to the results of our series (90%).…”

Funkcionalni i onkološki ishodi bolesnika liječenih frontolateralnom laringektomijom

“…18 Hendriksma navodi petogodišnji OS 63,7%, DSS 86%, a u čak 29,8% bolesnika došlo je do pojave lokalnog recidiva kod bolesnika koji su liječeni radioterapijom. 19 Uspoređujući funkcionalne ishode našeg istraživanja s onima iz literature, posebice pri usporedbi glasa nakon liječenja radioterapijom ili laserskom kirurgijom, dobili smo lošije rezultate. Ukupni GRBAS score u našoj studiji iznosi 6,2 dok je VHI score 37,6.…”

Early Glottic Cancer Treated by Transoral Laser Surgery Using Toluidine Blue for the Definition of the Surgical Margins: A Pilot Study

“…Tumor biology, clinical behavior and prognosis differ on the basis of its location: glottis, supraglottis or subglottis region [ 2 ]. Consequently, the methods of treatment vary according to the location, as well as the stage of the disease [ 3 ], from organ preservation strategies such as radiotherapy [ 4 ], transoral laser microsurgery (TLM) [ 5 , 6 ], and open horizontal partial laryngectomy [ 7 ] to demolitive surgery (total laryngectomy). The diagnosis of glottic cancer, more often than other laryngeal sites, is made in the early stage (Tis–T1–T2) due to the early onset of clinical symptoms, such as hoarseness or progressive dysphonia.…”