Recurrence Rate in Post Irradiated T1 and T2 Supraglottic and Glottic Carcinoma of the Larynx

Background: T1 and T2 carcinoma of the supraglottis and glottis can be treated by radiation or conservative surgery. Our aim was to study the recurrence rate following treatment with radiation alone, the sites of involvement, the risk factors involved and to assess the hemoglobin (Hb) levels in relation to the prognosis and treatment outcome. Materials and Methods: A total of 61 patients with T1 and T2 laryngeal carcinoma were enrolled for this purpose. One succumbed to death due to unrelated cause. All the patients were given external beam radiation and followed up for 3 years. Association of risk factors like smoking and alcohol were recorded and the pretreatment Hb levels were checked. Results: Local control rate at the end of 3 years was as follows: 53.57% for T1 and T2 supraglottic cancer and 87.5% for T1 and T2 glottic cancer. A maximum number of recurrence was found to be with infrahyoid supraglottic cancer. Parameters such as tumor extent and TNM staging, pretreatment Hb levels, histological differentiation, and continuance of risk factors significantly influenced the recurrence rate on univariate analysis, but by logistic regression table, significant p value was obtained only in the higher recurrence rate for infrahyoid supraglottic carcinoma, when compared to the other sites of the larynx. Conclusion: Early T1 and T2 laryngeal cancers can be treated by radiotherapy or surgery. The choice of therapy is dependent on both patient and treatment institution related factors. While T1 and T2 glottic cancers had a control rate by radiotherapy comparable to that by surgery, infrahyoid supraglottic cancers had a higher rate of recurrence by radiotherapy. Conservative partial laryngectomy, transoral laser surgery or other alternative techniques in radiotherapy may be considered in treating these tumors.