[Radiotherapy of cancer of the vocal cords. Report on 287 patients].

Therapeutic results in 287 glottic and subglottic carcinomas stage I-IV are reported. After primary irradiation and salvage surgery of recurrences the actuarial 10 year-NED probability for tumours with normal mobility of the vocal cords was 78%, for those with impaired mobility it was 60% and for tumours with complete fixation in stage III it was only 27%. The relative actuarial 10 year-survival probability of the same groups were 96%, 82% and 35%. Salvage surgery was performed in 48/51 patients (94%) with radioresistent tumours or recurrences and was successful in 37/48 (77%) of the patients. The larynx could be saved in 162/210 (77%) curative irradiated patients. Primary irradiation can be recommended as the method of choice in glottic carcinoma T 1 + 2. It can be proved also in T3-tumours as alternative to preoperative irradiation and laryngectomy if adequate follow-up is possible, otherwise combined preoperative irradiation and laryngectomy is preferred. Dose levels equivocal to CRE 19 are recommended for curative irradiation of T 1 + 2 N0-tumours. For more advanced tumours T3 + 4 and cervical metastases greater than 3 cm about 10% higher doses are needed. Different fractionation schedules for curative and preoperative irradiation are discussed. A highly significant dose-effect relation was found for dose levels above and below CRE 18.