Resumen de Definitive radiotherapy for T1 glottic squamous cell carcinoma: a 15-year Cruces University Hospital experience

Jon Cacicedo Fernández de Bobadilla, Francisco Casquero Ocio, Olga del Hoyo Álvarez, A. Gómez-Iturriaga, Lorea Martínez Indart, José Luis López Guerra, Pedro Bilbao Zulaica

• Purpose To evaluate the treatment outcomes for T1 N0 glottic carcinoma after definitive radiotherapy.

  Methods One hundred and seventeen patients treated with radical radiotherapy from 1990 to 2006 were retrospectively reviewed. The median follow-up duration for the entire group was 92 months (range 4�227). A median dose of 70 Gy (range 63�70 Gy) was administered. We determined the rates of local control (LC), regional control, overall survival (OS) and cause-specific survival (CSS) at 5, 10 and 15 years by Kaplan�Meier product-limit method. The Cox regression analysis was performed to identify significant prognostic factors for LC and survival. The incidence of secondary malignancies is also reported.

  Results The 5-, 10- and 15-year LC rates for the whole group were 84, 80.2 and 80.2 %, respectively. There were 20 local recurrences, of which 19 were salvaged with laryngectomy, giving an ultimate control rate of 90.6 %. The 5-/10-/15-year OS and CSS rates were 81.2 %/66.1 %/48.3 % and 90.6 %/90.6 %/90.6 %, respectively. None of the parameters analyzed exhibited a statistically significant relationship with LC. The age ?65 years had a statistically significant effect on OS (but not in CSS), with a hazard ratio of 2.45 (95 % confidence interval 1.29�4.66; p = 0.006). During follow-up, 26 patients (22 %) developed a secondary malignancy. Only two patients (1.7 %) presented with severe toxicity (edema and mucositis).

  Conclusions Radiotherapy alone offers a high likelihood of LC and an excellent CSS rate. In addition, the surgical approach for the salvage is a successful option.