Radiotherapeutic management of cancer of the supraglottis

One hundred eighty-five patients with cancer of the supraglottis were treated with curative intent by radiotherapy alone or combined with surgery over a 14-year period. Minimum follow-up was 3 years. Sixty-eight percent had Stage III or IV disease. Moderate-dose radiotherapy, with surgery in reserve, was the policy for the early lesions, and yielded a 3-year locoregional control rate of 76% for T1 N0/N1, T2 N0/N1, and T3 N0/N1 lesions combined. In this group, 84% of patients with locoregional control retained laryngeal function. The major complication rate was 4%. Patients with advanced disease were treated with preoperative radiotherapy and surgery, resulting in an overall 3-year no evidence of disease rate of 72%. Adverse prognostic factors in supraglottic cancer were the extent of the primary lesion and the presence of N2 or N3 nodes. Neither vocal cord fixation nor N1 nodes had a negative influence on survival in T3 and T4 disease.