Bilateral stage Ib glottic carcinoma: results of radiation therapy

Bilateral early carcinoma of the true vocal cords (stage T1bN0M0) makes up about 15% of all stage I carcinomas. Twenty-four patients with stage Ib glottic carcinoma (18 with involvement of the anterior commissure and six without) received a radical course of radiation therapy with the median dose of 6,600 rad (66 Gy) in 33 fractions calculated at midpoint. In 19 patients (80%) radiation therapy alone produced complete local control of the disease. In the five patients in whom treatment failed, the recurrent tumors were confined to the larynx and were noticed within 3 years of treatment. Surgery was subsequently performed in three of the five patients but was successful in only one. In 19 of the 24 patients, the voice sounded relatively normal after radiation therapy.