T1-T2 vocal cord carcinoma: a basis for comparing the results of radiotherapy and surgery.

This is an analysis of 304 patients with invasive, previously untreated T1-T2 squamous cell carcinoma of the glottic larynx treated with radiotherapy between October 1964 and December 1984. All patients had a minimum 2-year follow-up and 82% had at least 5 years of follow-up. Patients were excluded from the analysis of local control if they died within 2 years of treatment with the primary site continuously disease-free. Patients were staged according to the AJCC system and stratified by the surgical procedure that would have been required to resect the tumor. Stage T2 was subdivided into two subsets: T2a (normal mobility) and T2b (decreased mobility). The rates of local control with radiotherapy and the ultimate rates of local control, including patients salvaged surgically for a local recurrence, were as follows: T1, 159 of 171 (93%) and 166 of 171 (97%); T2a, 50 of 65 (77%) and 63 of 65 (97%); and T2b, 31 of 43 (72%) and 38 of 43 (88%). The rate of local control for patients with T1 lesions limited to one cord was not influenced by tumor extension to the anterior commissure. The overall incidence of serious complications was 5 of 304 (1.6%). The 5-year determinate survival rates were as follows: T1, 130 of 134 (97%); T2a, 43 of 46 (93%); and T2b, 29 of 33 (88%).