Radiotherapy versus laser microsurgery in the treatment of early glottic cancer

Abstract

Background

Glottic squamous cell carcinoma (SCC) in stages I or II can be treated by transoral CO₂ laser microsurgery (TLM) or exclusive radiotherapy (RT).

Objectives

To compare the oncological results of patients treated with TLM, to those treated with RT, in a tertiary hospital.

Material and methods

Data from patients diagnosed with glottic SCC in stages I and II between 2004 and 2018 were analyzed. Response to treatment was studied in terms of recurrence, local control and laryngeal preservation.

Results

Of 164 patients, 63.41% received treatment with TLM and 36.58% with RT. 26.21% presented a recurrence or progression of the tumor. Both treatments obtained good local control rates (84.15% in the case of TLM and 89.6% in the case of RT) and no significant association was found between tumor recurrence and type of treatment, nor with the involvement of the anterior commissure. However, treatment with RT obtained worse laryngeal preservation rate compared to TLM (81.6% and 100% respectively) (p < .001LR).

Conclusions and significance: Both treatments obtained good oncological results. There were no significant differences regarding local control. However, TLM obtained a better laryngeal preservation rate. The involvement of the anterior commissure was not a poor prognosis factor for tumor recurrence.

Chinese abstract

背景：经口CO2激光显微手术（TLM）或放射疗法（RT）可以治疗I期或II期声门鳞状细胞癌（SCC）。

目的：比较在三级医院接受TLM治疗和接受RT治疗的患者的肿瘤学结果。

材料和方法：分析了2004年和2018年期间被诊断为I期和II期声门SCC的患者的资料。从复发、局部控制和喉部保护的角度研究对治疗的反应。

结果：在164例患者中, 有63.41％的患者接受了TLM治疗, 而36.58％的患者接受了RT治疗。26.21％的患者表现肿瘤复发或增长。两种治疗均取得良好的局部控制率（TLM为84.15％, RT为89.6％）, 并且没有发现肿瘤复发和治疗类型之间显著联系, 也与前部连合没有关系。然而, 与TLM相比, RT治疗的喉保存率差（分别为81.6％和100％）（p <.001LR）。

结论和意义：两种治疗均取得良好的肿瘤学效果。两者在局部控制上没有显著差异。但是, TLM的保护喉咙率更高。前部连合并非肿瘤复发的弱预后因素。

Keywords:

• Squamous cell carcinoma
• glottis
• transoral laser microsurgery
• recurrence
• local control
• laryngeal preservation

Disclosure statement

No potential conflict of interest was reported by the author(s).