Outcome of T2 Glottic Cancer Treated with Radiotherapy Alone or Concurrent Chemo-Radiotherapy

Current evidence suggests that radiotherapy (RT) provides excellent locoregional control and survival rates, exceeding 90% at five years for stage I glottic cancer, particularly when hypo-fractionated regimens are employed. However, outcomes for stage II disease are less favorable, even with modifications to fractionation. In this retrospective study, we analyzed oncological outcomes in a cohort of 121 patients with T2N0M0 glottic cancer in an effort to identify the most effective treatment modality. Our findings indicate that concurrent chemoradiotherapy (CCRT) is the most effective treatment for this patient population. Specifically, the 5-year and 10-year locoregional control rates for patients receiving CCRT were 88.5% and 83.2%, respectively, compared to 72.8% and 69.6% for those treated with definitive RT alone (adjusted hazard ratio: 0.30, 95% confidence interval 0.12–0.76, p = 0.011). Notably, the most significant treatment effects were observed in patients with subglottic extension and vocal cord mobility impairment, which are established poor prognostic indicators for glottic cancer. Conclusion: CCRT improves local control, recurrence-free survival, and overall survival in T2N0M0 glottic cancer, albeit with high toxicity.