The value of preoperative radiotherapy response to maximizing laryngeal conservation in early stage supraglottic carcinoma.

This study is a retrospective review between 1976 and 1986 of 12 patients with T1(1) and T2(11) NO supraglottic cancers which were managed by a method that utilized planned preoperative radiotherapy (45-51 Gy) to the primary and bilateral necks. If adequate tumor response (greater than 75% reduction in size) was noted by laryngoscopy, therapy was completed at levels of 65-70 Gy to the primary. If a lesser tumor response was noted, the patient underwent supraglottic laryngectomy. Six patients completed primary radiotherapy (RT-RT) and six patients underwent supraglottic laryngectomy (RT-SG). There was evidence of residual tumor in three of six RT-SG patients. No tumor recurred at any site. Laryngeal function was preserved in all patients. Absolute survival was 58% at 67 months. This approach is oncologically sound and permits maximal laryngeal conservation.