TITLE:
Clinical Outcome of Definitive Radiotherapy and/or Surgery in T1-2N0M0 Glottic Squamous Cell Carcinoma: A Single Institution Retrospective Report
AUTHORS:
Dina Ragab Diab Ibrahim, Anas Mohamed Askoura, Mohammed Aleem
KEYWORDS:
Larynx, Glottic Squamous Cell Carcinoma, Outcome, Radiotherapy, Surgery
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.2,
February
26,
2018
ABSTRACT: Background: The current treatment options of early glottic
carcinoma are radiotherapy; trans laser microsurgery, and open surgery.
However, the best treatment is still controversial due to lack of randomized
controlled trials. We aimed to evaluate the treatment results and the
prognostic factors of local control of early glottic squamous cell carcinoma
patients (GSCC) T1-2N0M0 treated at our institution. Material and Methods: We retrospectively studied the charts of 52 patients
with early GSCC T1-T2N0M0 from 2010-2015 at the Clinical Oncology Department,
Ain-Shams University. 24 patients had T1 and 28 had T2 early glottic carcinoma.
The overall survival OS, local control rate, and laryngeal preservation rate
were evaluated. Kaplan-Meier method, Cox proportional hazards model were used
to analyze the data. Results: Median duration of follow-up was 13
months. Thirty-eight patients received radiation treatment alone (73.1%),
7.7% of the patients underwent surgery alone, and 19.2% of the patients had
surgery combined with radiotherapy. Local recurrence after radiation failure
developed in 6/52 patients, all had T2 disease and were salvaged by total
laryngectomy. The ultimate local control rate was 88.5%, and the ultimate
laryngeal preservation rate was 77.2% (40/52 patients). The median OS of the 52
patients was 13 months (range 2 - 46
months). Univariate analysis of factors associated with poor local control
showed that age > 60 years was the only significant factor (P = 0.048). Conclusion: Radiotherapy
achieves high local control and laryngeal preservation rates for patients with
early glottic carcinoma, and is associated with a low rate of severe
complications compared to surgery. Salvage surgery is feasible after
radiotherapy failure.