A Combination of Endoscopic CO2 Laser Microsurgery and Radiotherapy for Treatment of T2N0M0 Glottic Carcinoma

The aims of this study were to evaluate the results of CO2 laser surgery alone and CO2 laser surgery combined with radiotherapy in patients with T2N0M0 glottic carcinoma. A retrospective analysis was conducted of 35 cases of T2N0M0 glottic carcinoma. Fourteen patients with normal vocal cord mobility were treated with endoscopic CO2 laser surgery alone. The remaining 21 patients were treated with CO2 laser surgery followed by radiotherapy (44 70 Gy, including low-dose carboplatin chemoradiotherapy). Main outcome measures were local control, organ preservation, recurrence, 5-year survival, and successful salvage in cases of recurrence. We evaluated the patient’s voice with the psychoacoustics GRBAS scale, maximum phonation time (MPT), and airflow rate (AFR) obtained by aerodynamic tests. Mean follow-up period was 5 years. Among the 35 T2N0M0 patients, 5-year survival and 5-year voice preservation rates were 97% and 89%, respectively. Local recurrence occurred in 7 of these patients (20%); 4 of 7 local recurrences were successfully re-treated by laser surgery. Total laryngectomy was necessary for salvage treatment in the remaining 3 patients. The post-treatment voice qualities were judged to be the same or improved over pretreatment qualities. There was little change in MPT and AFR after treatment in non-recurrence patients. CO2 laser microsurgery is an excellent tool for treating selected cases of T2N0M0 glottic carcinoma. CO2 laser surgery followed by radiotherapy is a useful option for treatment of T2N0M0 glottic carcinoma.