Factors influencing the success of radiation therapy for T2 and T3 glottic carcinomas. Importance of cord mobility and sex.

One hundred ninety patients with T2 and 70 patients with T3 carcinoma of the glottis were treated by definitive radiation therapy at the Massachusetts General Hospital from 1952 to 1978; the results were analyzed. The 5-year actuarial no evidence of disease (NED) rate for the T2 lesions was 71%; including salvage surgery, 85%. The rate for T3 lesions was 36%; including surgical salvage, 57%. The most significant factors influencing the radiotherapeutic results included the mobility of the diseased cord and the sex of the patient. Those patients with impaired cord mobility, designated as T2b, and fixed cord, T3, had a poor prognosis. The female patients had a more favorable outlook stage for stage. Therefore, these factors must be taken into consideration in the management of T2 and T3 lesions if optimum therapeutic results and preservation of voice are the goals. A proposed treatment policy for carcinoma of the glottic larynx is presented.