Radiotherapy in the Treatment of Early-Stage Glottic Laryngeal Carcinoma - Experience from a Hospital Center

Laryngeal carcinoma represents 1-2% of all malignant neoplasms worldwide. Glottic laryngeal carcinoma (GLC) can present with involvement restricted to the vocal cords or extend to the anterior and posterior commissures, with approximately 3/4 of cases being diagnosed in early stages. Radiotherapy (RT) and laser surgery have become the standard of care for the treatment of early-stage GLC, offering high disease control rates and the advantage of organ preservation with maintenance of phonatory function. The primary objective of this study is to evaluate overall survival (OS), disease-free survival (DFS), and treatment-related toxicity in patients with stage cT1-T2N0M0 GLC.

We retrospectively analyzed 16 cases of cT1-T2N0M0 glottic laryngeal carcinoma diagnosed and treated in our Department of Radiotherapy from January 2018 to June 2023. Radiotherapy regimens applied consisted of 70 Gy in 35 fractions of 2 Gy/day and 63 Gy in 28 fractions of 2.25 Gy/day. Data collection was performed through a review of clinical records. Data were analyzed using IBM SPSS Statistics version 29. We conducted a descriptive analysis of sociodemographic variables, assessed OS and DFS rates, and evaluated treatment-related toxicities based on the RTOG/EORTC toxicity scale. Survival analysis was conducted using the Kaplan-Meier method, and comparisons were made using the Log-Rank test, with a significance level of 0.05 considered for statistical inference.

The median age at diagnosis was 65.5 years, and the mean follow-up time was approximately 25 months. For the time period analyzed, OS was 87.5%, and DFS reached 93.8%. Among the cases analyzed, 50% presented involvement of the anterior commissure of the larynx, and at 5 years, an OS rate of 70% and a DFS of 50% were observed (without statistically significant differences). The most frequent acute toxicity symptoms were odynophagia (n=11/16) and erythema (n=13/16). Odynophagia manifested approximately 16 days after the start of treatment, and erythema appeared after 28 days of treatment. No acute toxicity symptoms led to treatment interruption.

Radiotherapy treatment in patients with cT1-T2N0 glottic laryngeal carcinoma demonstrated favorable OS and DFS results, consistent with the literature. Additionally, RT-related toxicity was well-tolerated in the studied population, as no patients discontinued treatment due to toxicity. The analyzed sample suggests that RT remains an effective treatment option for early-stage GLC patients, offering a promising perspective for disease control and preservation of phonatory function. Nevertheless, it is essential to emphasize the need for long-term follow-up of these patients to evaluate long-term survival and the incidence of late toxicities.