Exclusive radiotherapy for stage T1-T2N0M0 lanryngeal cancer: retrospective study of 59 patients at CFB and CHU de Caen

Eur Ann Otorhinolaryngol Head Neck Dis. 2013 Nov;130(5):251-6. doi: 10.1016/j.anorl.2012.04.013. Epub 2013 Jun 10.

Abstract

Objective: Study of patients with stage T1N0M0 or T2N0M0 glottic cancer treated by exclusive radiotherapy and comparison of the survival and functional results of this series with those of the literature.

Method: Retrospective study of stage T1N0M0 or T2N0M0 glottic cancers diagnosed between 1st January 2000 and 31st December 2010 and treated by exclusive radiotherapy. Evaluation of survival, recurrence and larynx preservation rates.

Study centres: CLCC François-Baclesse and CHU de Caen.

Patients: Fifty-nine patients (53 men and sixwomen) treated for glottic cancer (57 squamous cell carcinomas, two verrucous carcinomas) comprising 51 T1N0M0 and eight T2N0M0 tumours. Treatment with exclusive radiotherapy (mean dose of 70 Grays limited to the thyroid cartilage for 57 patients, with lymph node irradiation for two patients).

Results: In this series, five (9.8%) patients with stage T1N0M0 glottic cancer and three patients (37.5%) with stage T2N0M0 glottic cancer relapsed, corresponding to a global recurrence rate of 13.6%. Three of the eight recurrences involved lymph nodes exclusively (N), two patients relapsed exclusively at the primary tumour site (T) and three patients presented local and lymph node recurrence (T and N). Treatment consisted of salvage total laryngectomy with bilateral cervical lymph node dissection in three cases, bilateral cervical lymph node dissection and sensitized radiotherapy in two cases, exclusive chemotherapy in one case, cervical lymph node dissection and cervical radiotherapy in one case. The last patient with recurrence died prior to salvage therapy. The larynx preservation rate was 94.9%.

Conclusion: In comparison with the literature, treatment of stage T1-T2N0M0 glottic cancer by exclusive radiotherapy gives very good results, with a larynx preservation rate of 95%.

Keywords: Early stage; Exclusive radiotherapy; Glottic cancer; Larynx preservation; Recurrence.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Verrucous / mortality
  • Carcinoma, Verrucous / pathology*
  • Carcinoma, Verrucous / radiotherapy*
  • Carcinoma, Verrucous / surgery
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology*
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery
  • Laryngectomy
  • Lymphatic Irradiation
  • Lymphatic Metastasis / radiotherapy
  • Male
  • Middle Aged
  • Neck Dissection
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Organ Preservation
  • Postoperative Complications / mortality
  • Postoperative Complications / radiotherapy
  • Postoperative Complications / surgery
  • Radiotherapy Dosage
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Salvage Therapy
  • Survival Analysis