T4 Glottic carcinoma: oncological results and survival rate

Abstract

Objectives/Background: The best course of action in the case of T4 glottic carcinoma is chosen for each individual case. The aim of this study was to evaluate the potential prognostic factors and influence of postoperative and radical radiotherapy on the survival rate of patients suffering from T4 glottic carcinoma and to analyze the most appropriate conservative treatment for these patients. Methods: Study Design: A retrospective study (1995-2000) enrolled 63 patients with squamo-cellular glottic cancer in T4N1M0 stage, monitored for 5 years, divided into two groups: 30 postoperatively irradiated patients and 33 radically irradiated patients. Analysed variables were: age, sex, total therapeutical dose, number of fractions, dose per fraction and type of radiotherapeutical treatment. Standard therapeutical fractionation regimens were used, with daily sessions of 2-3 Gy, five times a week. Radiotherapy consisted of mega-voltage 10 MEV X-ray therapy. Log Rank test, Kaplan-Meier survival study, t-test, Pearson X2 - test and Cox regression were used in order to select the factors with independent effect. Results: Multivariate analysis demonstrated that none of the predictors, not even the type of radiation therapy, were statistically significant, with independent influence on survival. Conclusion: There is no significant difference in survival of patients with T4 glottic carcinoma among postoperatively and radically irradiated patients. Our results imply that the optimal radiotherapeutic modality for these patients is a total therapeutical dose no less than 65 Gy and daily fractionation with dose no less than 2,51Gy.