Abstract
Objects: The aim of this study was to evaluate the clinical features and salvage surgery after radiotherapy in patients with early glottic cancer.
Patients and Methods: From 2001 to 2006, 88 patients with T1 and T2 glottic cancer were treated with radiation alone (82 patients)and chemoradiation(6 patients). In general, T1 cancers with bulky tumors and T2 cancers without deep invasion were treated with hyperfractionated radiotherapy (19 patients). T2 cancers with deep invasion were treated with platinum-based concurrent chemoradiation. Local failure after radiotherapy occurred in 14 patients (rest in 4 patients and recurrence in 10 patients). Median follow-up was 31 months.
Results: Local control rates with radiotherapy were 90％, 75％ and 81％ in T1a, T1b, T2 glottic cancer, respectively. Local recurrence after radiotherapy occurred in 3 out of 6 patients (50％) with widely extended T1b glottic cancer. All patients with local failure underwent salvage surgery as follows, LASER cordectomy (6 patients), vertical partial laryngectomy (4 patients), and total laryngectomy (4 patients). 2 patients with recurrent local disease after salvage LASER cordectomy were both salvaged successfully via total laryngectomy. The laryngeal preservation rate was 57％ in patients with local failure of radiotherapy.
Conclusions: Our findings indicate that the extent of the tumor is an important predictor of radiotherapy outcomes in T1b glottic cancer. Although the follow-up periods were not long enough, favorable local control and laryngeal preservation in patients with local failure of radiotherapy were obtained. Treatment strategies for advanced aged patients with T2 glottic cancer require resolution.
