Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_29_2688 - Radiation Therapy for True Vocal Cord Carcinoma in Situ: A 55 Year Single-Institution Experience

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Radiation Therapy for True Vocal Cord Carcinoma in Situ: A 55 Year Single-Institution Experience
J. D. Mayfield1, C. E. Mercado2, W. M. Mendenhall2, C. G. Morris2, R. J. Amdur2, and K. E. Hitchcock2; 1University of Florida, Gainesville, FL, 2Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL

Purpose/Objective(s): To report long-term outcomes after definitive radiotherapy (RT) for carcinoma in situ (CIS) of the true vocal cords (TVC).

Materials/Methods: Under institutional review board approval, we reviewed the medical records of previously unirradiated patients treated with definitive RT for CIS of the TVC to assess clinical outcomes at our institution. Treatment-related complications were tabulated from all on-treatment and follow-up notes. The Kaplan-Meier product limit estimator provided estimates of overall survival, cause-specific survival, and local control.

Results: Forty-nine patients treated between July 1961 and October 2017 were eligible for inclusion in the analysis. Patients received RT with either cobalt-60 (57%) or MV photons (43%), delivered using 2 or 3 treatment fields. The median RT dose was 61 Gy (range, 56 Gy–66.5 Gy) at 2.25 Gy per fraction. Approximately half of the patients (23/49) were referred for RT because of disease recurrence after at least one vocal cord stripping procedure. The median age at diagnosis was 64 years old (range, 32-85); most patients were male (86%). The median follow-up of surviving patients was 9.4 years (range, 2-16.6). The local control rate at 5 and 10 years was 93%. Five patients (10%) developed a local recurrence with invasive carcinoma after RT at 6 months, 1 year, 5 years, 11 years, or 13 years. Four patients were surgically salvaged with a total laryngectomy; 1 patient declined further treatment. One patient had an isolated neck recurrence at 30 months after treatment; salvage treatment with neck dissection and postoperative RT was unsuccessful. At 10 years, the cause-specific survival rate was 100%. At last follow-up, 11 patients were alive without disease (22%), 1 patient was alive with recurrent disease (2%), 36 patients had died of intercurrent disease (73%), and 1 patient had died with recurrent disease (2%). No late complications were observed.

Conclusion: Definitive RT to approximately 63 Gy at 2.25 Gy per fraction for CIS of the TVC provides excellent long-term disease control.

Author Disclosure: J.D. Mayfield: None. C.E. Mercado: None. W.M. Mendenhall: Employee; University of Florida. C.G. Morris: None. R.J. Amdur: Partnership; RadOnc eLearning Center, Inc. Head and Neck Oral Exam Director; ABR. RRC Member; ACGME. Editorial Board; AJCO, JCO, PRO. K.E. Hitchcock: None.

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