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EP-1113: Prediction of radiation treatment outcome in patients with tongue cancer
ESTRO 33, 2014 tested again in a wider series with a longer follow-up time because, if confirmed, this finding could facilitate treatment selection in clinical practice. In any case, virus detection would have a decisive impact on diagnostic/decisional algorithms, especially if detection methods are implemented on cytological samples (e.g., thin-prep). In fact, the detection of an oncogenic virus in a FNAB or histological sample compatible with SCC would certainly be helpful when searching for the primary tumor, would guide the biopsy site choice and would indicate a bilateral tonsillectomy if high-risk HPV is detected. EP-1111 Dermatitis in the treatment of nasopharyngeal carcinoma: correlation with chemotherapy and irradiation dose K. Lee1, W.Y.C. Kong1, W.Y.V. Choi1, K.H.A. Leung1, W.L. Ho1, M.C.R. Chau1, K.C.R. Ngan1 1 Queen Elizabeth Hospital, Clinical Oncology, Hong Kong, Hong Kong (SAR) China Purpose/Objective: Chemo-radiation therapy is widely used to treat nasopharyngeal carcinoma (NPC), and dermatitis is a common and debilitating complication associated with this type of treatment. In this study, the effect of chemotherapy and irradiation dose on the severity and onset time of dermatitis is examined. Materials and Methods: 164 NPC patients treated with IMRT or TomoTherapy during the period of March 2012 – March 2013 were retrospectively analyzed. These patients received ongoing skin complication assessment during the course of treatment, and the complication was graded according to CTCAE v3.0. The irradiation dose to the skin, which was contoured as a structure 3mm in thickness along the whole extension of nodal target, was extracted from the treatment planning computer. Results: A total of 164 patients were analyzed. 50.6% (83/164) of the patients developed Grade 1, 39.6% (65/164) developed Grade 2 and 9.1% (15/164) developed Grade 3 dermatitis. Patients who received TomoTherapy (n=102), and IMRT (n=62) showed no significant difference in the worst dermatitis grade attained by the patient. Results showed 50.6% (83/164) of the patients received Grade 1 dermatitis, 39.6% (65/164) received Grade 2 and 9.1% (15/164) received Grade 3. Patients treated by chemo-radiation therapy attained significantly worst dermatitis grade than patients treated with radiotherapy alone (p = 0.006). However, there is no significant difference in dermatitis grade among patients treated with different chemotherapy schemes (concurrent only, concurrent plus adjuvant and concurrent plus induction chemotherapy). In radiotherapy alone group, the dose index (the near maximum dose given by the dose received in 1% of the skin structure, denoted as D01) between patients who received Grade 1 and Grade 2/3 were significantly different (p = 0.024). With D01 less than 62Gy, 89.5% of the patients received only Grade 1 skin complication, and this was reduced to 50% when D01 was greater than 62Gy. However, no dose index was significantly different between the Grade 1 and Grade 2/3 patients in the chemo-radiation therapy group. Over 60% of the patients started to show dermatitis on or after the 23rd fraction of treatment. With the use of concurrent plus induction chemotherapy, more patients expressed dermatitis at an earlier stage of treatment. Conclusions: Increased radiation dose and the use of chemotherapy increased the severity of dermatitis. For RT-alone patients, a threshold of 62Gy for D01 reduces the probably of receiving Grade 2 or higher dermatitis to about 10%. When chemo-radiation therapy was used, the effect of chemotherapy may overwhelm that imposed by radiation. The use of induction plus concurrent radiotherapy may also result in earlier expression of the skin complication, as compared to other chemotherapy schemes. These information will be useful to guide skin sparing in treatment planning as well as to anticipate the severity of complication in different treatment regimes of NPC.
S23 preserving treatments, including radiation therapy with or without chemotherapy, have recently been used for head and neck cancers, there have been few reports on treatment results for gingival cancer. The aim of this study was to review the efficacy and toxicity of radiation therapy with concurrent superselective intra-arterial chemotherapy in the treatment of gingival carcinoma. Materials and Methods: Between April 2006 and March 2011, 34 patients with gingival carcinoma and no distant metastasis underwent radiation therapy with concurrent superselective intra-arterial chemotherapy with curative intent at our institution. All patients were histopathologically diagnosed with squamous cell carcinoma of the gingiva by biopsy. Treatment consisted of daily external irradiation and concurrent superselective intra-arterial infusion with cisplatin (5 mg/m2/day) and docetaxel (10 mg/m2/week). Chemotherapy was initiated at the beginning of radiation therapy. Fraction size was 2 Gy and was delivered daily, 5 days per week, using 6 MV X-rays. After a total dose of 40 Gy had been delivered to the gross tumors and neck lymph node areas, an additional 20 Gy was delivered to the gross tumors within the shrunken field. A median total dose of 60 Gy in 30 fractions was delivered to tumors. Results: Of the 34 patients, 32 (94%) completed chemoradiation therapy without interruption. Twenty-nine patients (85%) achieved a complete response (CR) and 5 had residual tumors. Of the 29 patients with a CR, 2 had local recurrences and 1 had distant metastasis at 1-15 months after treatment. At both 3 and 5 years after treatment, the local control rates were 75%. Twenty-six of the 34 patients had survived at a median followup time of 36 months (range, 12-79 months); 4 had died of cancer and 4 had died of non-cancer-related causes. At both 3 and 5 years after treatment, the overall survival rates were 79% and the cause-specific survival rates were 85%. Therapy-related toxicities were evaluated according to the CommonTerminology Criteria for Adverse Events v4.0 (2009). Dermatitis and mucositis developed in most patients, they were transient and manageable. There were no patients with grade 4 or 5 acute toxicities. Osteoradionecrosis of the mandibular bone only developed in 1 patient after treatment. Conclusions: Radiation therapy with concurrent superselective intraarterial chemotherapy was effective and safe in the treatment of gingival carcinoma. This treatment may be a promising curative and organ-preserving treatment option for gingival carcinoma. EP-1113 Prediction of radiation treatment outcome in patients with tongue cancer A. Gevorkov1, A. Boyko1, L. Zavalishina2, A. Chernichenko1, I. Reshetov3, R. Plavnik4, E. Khmelevsky1, N. Rubtsova5, O. Malysheva5, A. Gladyshev6 1 Moscow Research Gerzen Oncology Institut, Radiation Oncology, oscow, Russian Federation 2 Moscow Research Gerzen Oncology Institut, Pathology, Moscow, Russian Federation 3 Moscow Research Gerzen Oncology Institut, Head and Neck Surgery, Moscow, Russian Federation 4 Moscow Research Gerzen Oncology Institut, Medical Physics, Moscow, Russian Federation 5 Moscow Research Gerzen Oncology Institut, Radiology, Moscow, Russian Federation 6 Moscow Research Gerzen Oncology Institut, Endoscopy, Moscow, Russian Federation Purpose/Objective: To identify potential predictors of preoperative or radical radiation therapy effectiveness in patients with cancer of the tongue.
EP-1112 Radiation therapy with concurrent superselective intra-arterial chemotherapy for gingival carcinoma Y. Mukai1, M. Hata1, K. Mitsudo2, I. Koike1, T. Koizumi2, S. Oguri2, M. Kioi2, M. Omura3, I. Tohnai2, T. Inoue1 1 Yokohama City University Graduate School of Medicine, Radiology, Yokohama, Japan 2 Yokohama City University Graduate School of Medicine, Oral and Maxillofacial Surgery, Yokohama, Japan 3 Shonankamakura General Hospital, Radiation Oncology, Kamakura, Japan
Materials and Methods: We assessed 130 patients with base of tongue tumors (n = 39, 30%) and the oral tongue cancer (n = 91 , 70%) who received treatment between 2003 and 2012. The study included 74 (57%) men and 56 (43% ) women. Most patients had stage III (39 %) and IV (35 %) squamous cell carcinoma, with invasive growth at 88% and lymph node metastases in 70%. Concurrent chemoradiotherapy with 5FU + cisplatin or cetuximab + cisplatin was performed in 102 (78.5%) patients. Response to treatment was evaluated by RECIST 1.1. Patients in whom response ≥60% was seen were then treated definitively with radical radiation therapy (n=44, 34%). Patients in whom response ≤60% was seen underwent surgery (n=86, 66%). Operations were performed in 38% patients with base of tongue cancer and 78% with oral tongue cancer. Organ-sparing surgery was done in 33% base of tongue tumors and 76% oral tongue cancer. Median follow up period was 38,5±30 months.
Purpose/Objective: The standard treatment for oral cancer remains surgery. Nevertheless, patients with gingival cancer treated with surgeries often accept a deteriorated quality of life. Although organ-
Results: Five year PFS was 71% for base of tongue cancer and 52% for oral tongue cancer. In univariate analysis most informative predictors (p <0.05) were gender, alcohol intake, comorbidities - a form of tumor
S24 growth, perineural invasion, p21, COX -2, p53, E cadherin, VEGF, Bcl- 2 and Ki- 67expression. Multi-factorial study showed that the most probable relationship (p less than 0.06 ) with localrecurrence demostrated regular use of alcohol , comorbidities, tumor location , perineural invasion , the expression of proteins - p53, COX- 2 and E cadherin. Based on multivariate statistical analysis of the contribution of clinical, morphological and molecular predictors combined predictive model was developed (including a total of 15 factors). Conclusions: Cancer of the base of tongue is more radiosensitive and promising in terms of the radical conservative treatment. EP-1114 A feasibility study of concurrent cetuximab during induction chemotherapy and IMRT for stage IV head and neck cancer J.C. Lin1, W.Y. Wang2, S.A. Liu3, C.W. Twu3, P.J. Lin1, Y.C. Liu1 1 Taichung Veterans General Hospital, Department of Radiation Oncology, Taichung, Taiwan 2 Hung Kuang University, Department of Nursing, Taichung, Taiwan 3 Taichung Veterans General Hospital, Department of Otorhinolaryngology, Taichung, Taiwan
ESTRO 33, 2014 Acute and late toxicities are reported in table 1. Acute skin toxicity and neck edema were mostly detected in the adjuvant radiotherapy group, while dysphagia G1-2, mucositis G3-4 and dry mouth were mostly registered in RR group. Late skin toxicity and neck edema incidence is higher in the adjuvant radiotherapy group; that of mild laryngeal edema and dry mouth in the RR group. Univariate analysis of survival (log rank test) for all endpoints confirmed the role of T, N and clinical stage as prognostic factors. There was no significant difference in disease free survival (DFS, LRFS, NRFS and MFS) between the different treatment modalities. At multivariate analysis (Cox Regression) nodal involvement at presentation was the only factor useful to predict disease-free survival. 21 pts underwent salvage total laryngectomy: 18 after RR and 3 after SHLR (p=NS) (Figure 1).
Purpose/Objective: To evaluate the feasibility of adding cetuximab during the whole course of induction chemotherapy (IndCT) + intensitymodulated radiotherapy (IMRT) for patients with stage IV squamous cell carcinoma of head and neck (SCCHN). Materials and Methods: The IndCT consists of cisplatin 60 mg/m2, alternating with 5-fluorouracil 2500 mg/m2 plus leucovorin 250 mg/m2 by an outpatient weekly schedule for a total of 10 weeks. IMRT 70 Gy/35 fractions were delivered to the original primary tumor and metastatic nodal region. Cetuximab 400 mg/m2 day 1, then 250 mg/m2 were administered every week during the whole chemoradiotherapy period. Results: Twenty-three patients were recruited. Patient compliance is good. Grade 3/4 toxicity during cetuximab-IndCT phase included leucopenia (0%), anemia (17.4%), thrombocytopenia (8.7%), vomiting (4.3%), mucositis (4.3%) and skin rash (17.4%). Response evaluated after cetuximab-IndCT showed 39.1% complete response, 47.8% partial response, and stable disease 13.1%. After cetuximab-IMRT, we observed 77.3% complete response, 18.2% partial response, and 4.5% stable disease. The major side effects during cetuximab-IMRT phase were 77.3% grade 3/4 mucositis and 45.4% grade 3/4 radiation dermatitis. All 23 patients could finish 10 weekly cetuximab during IndCT smoothly but 17/22 patients completed 7 weekly cetuximab during IMRT. One patient with stable disease after cetuximab-IndCT refused cetuximab-IMRT and shifted to surgery. Conclusions: Concurrent cetuximab, in combination with IndCT-IMRT is feasible with high response rate in patients with stage IV SCCHN. EP-1115 Clinical outcomes and toxicity in supraglottic laryngeal cancer treated with radical or adjuvant radiotherapy S. Pedretti1, L. Costa2, F. Foscarini1, S. Ciccarelli1, G. Pascale1, L. Pegurri2, N. Pasinetti2, S. Tonoli2, M. Buglione1, S.M. Magrini1 1 Brescia University, Radiation Oncology, Brescia, Italy 2 Spedali Civili di Brescia, Radiation Oncology, Brescia, Italy Purpose/Objective: To analyze clinical outcomes, acute and late toxicity, survival and laryngeal preservation, after different treatment for patients with supraglottic laryngeal cancer: radiotherapy alone (RR), radiotherapy after supraglottic horizontal laryngectomy (SHLR) and radiotherapy after total laryngectomy (TLR). Materials and Methods: From 1984 to 2012 708 patients (pts) were treated at Radiation Oncology Department of Spedali Civili - Brescia: 324 with RR, 126 with SHLR and 258 with TLR. 3 pts were excluded from analysis because T4 and subjected to not adequate SHLR. The acute and late toxicity (CTCAE v.4.0) were analyzed and related with radiotherapy purpose (χ2 test). Survival and laryngeal preservation were correlated with other known prognostic factors. Results: pts undergoing RR were older (p= 0.001), had worse PS (p= 0.000) and more comorbidity (p= 0.003) than the others. Pts undergoing TLR had more frequently locally advanced disease (T3-T4 52%) and nodal involvement (N+ 77%) (p=0.000), while pts treated with SHLR had smaller tumors (T2 63%) with cervical adenopathy (71%). 526, 157 and 22 pts had respectively 2D, 3D and IMRT treatment. Only 78 pts had concomitant chemotherapy with weekly CDDP (40mg/m2. RT doses on T and N were significantly higher in pts treated with RR (p= 0.000). The pattern of recurrence analysis showed no significant difference in the incidence of local or nodal recurrence.
Conclusions: In this historical series, radiotherapy, alone or in combination with chemotherapy, provides loco-regional control comparable to combined treatments (both after conservative and demolitive surgery), with no increase in severe late toxicity and allowing larynx preservation.
S23 preserving treatments, including radiation therapy with or without chemotherapy, have recently been used for head and neck cancers, there have been few reports on treatment results for gingival cancer. The aim of this study was to review the efficacy and toxicity of radiation therapy with concurrent superselective intra-arterial chemotherapy in the treatment of gingival carcinoma. Materials and Methods: Between April 2006 and March 2011, 34 patients with gingival carcinoma and no distant metastasis underwent radiation therapy with concurrent superselective intra-arterial chemotherapy with curative intent at our institution. All patients were histopathologically diagnosed with squamous cell carcinoma of the gingiva by biopsy. Treatment consisted of daily external irradiation and concurrent superselective intra-arterial infusion with cisplatin (5 mg/m2/day) and docetaxel (10 mg/m2/week). Chemotherapy was initiated at the beginning of radiation therapy. Fraction size was 2 Gy and was delivered daily, 5 days per week, using 6 MV X-rays. After a total dose of 40 Gy had been delivered to the gross tumors and neck lymph node areas, an additional 20 Gy was delivered to the gross tumors within the shrunken field. A median total dose of 60 Gy in 30 fractions was delivered to tumors. Results: Of the 34 patients, 32 (94%) completed chemoradiation therapy without interruption. Twenty-nine patients (85%) achieved a complete response (CR) and 5 had residual tumors. Of the 29 patients with a CR, 2 had local recurrences and 1 had distant metastasis at 1-15 months after treatment. At both 3 and 5 years after treatment, the local control rates were 75%. Twenty-six of the 34 patients had survived at a median followup time of 36 months (range, 12-79 months); 4 had died of cancer and 4 had died of non-cancer-related causes. At both 3 and 5 years after treatment, the overall survival rates were 79% and the cause-specific survival rates were 85%. Therapy-related toxicities were evaluated according to the CommonTerminology Criteria for Adverse Events v4.0 (2009). Dermatitis and mucositis developed in most patients, they were transient and manageable. There were no patients with grade 4 or 5 acute toxicities. Osteoradionecrosis of the mandibular bone only developed in 1 patient after treatment. Conclusions: Radiation therapy with concurrent superselective intraarterial chemotherapy was effective and safe in the treatment of gingival carcinoma. This treatment may be a promising curative and organ-preserving treatment option for gingival carcinoma. EP-1113 Prediction of radiation treatment outcome in patients with tongue cancer A. Gevorkov1, A. Boyko1, L. Zavalishina2, A. Chernichenko1, I. Reshetov3, R. Plavnik4, E. Khmelevsky1, N. Rubtsova5, O. Malysheva5, A. Gladyshev6 1 Moscow Research Gerzen Oncology Institut, Radiation Oncology, oscow, Russian Federation 2 Moscow Research Gerzen Oncology Institut, Pathology, Moscow, Russian Federation 3 Moscow Research Gerzen Oncology Institut, Head and Neck Surgery, Moscow, Russian Federation 4 Moscow Research Gerzen Oncology Institut, Medical Physics, Moscow, Russian Federation 5 Moscow Research Gerzen Oncology Institut, Radiology, Moscow, Russian Federation 6 Moscow Research Gerzen Oncology Institut, Endoscopy, Moscow, Russian Federation Purpose/Objective: To identify potential predictors of preoperative or radical radiation therapy effectiveness in patients with cancer of the tongue.
EP-1112 Radiation therapy with concurrent superselective intra-arterial chemotherapy for gingival carcinoma Y. Mukai1, M. Hata1, K. Mitsudo2, I. Koike1, T. Koizumi2, S. Oguri2, M. Kioi2, M. Omura3, I. Tohnai2, T. Inoue1 1 Yokohama City University Graduate School of Medicine, Radiology, Yokohama, Japan 2 Yokohama City University Graduate School of Medicine, Oral and Maxillofacial Surgery, Yokohama, Japan 3 Shonankamakura General Hospital, Radiation Oncology, Kamakura, Japan
Materials and Methods: We assessed 130 patients with base of tongue tumors (n = 39, 30%) and the oral tongue cancer (n = 91 , 70%) who received treatment between 2003 and 2012. The study included 74 (57%) men and 56 (43% ) women. Most patients had stage III (39 %) and IV (35 %) squamous cell carcinoma, with invasive growth at 88% and lymph node metastases in 70%. Concurrent chemoradiotherapy with 5FU + cisplatin or cetuximab + cisplatin was performed in 102 (78.5%) patients. Response to treatment was evaluated by RECIST 1.1. Patients in whom response ≥60% was seen were then treated definitively with radical radiation therapy (n=44, 34%). Patients in whom response ≤60% was seen underwent surgery (n=86, 66%). Operations were performed in 38% patients with base of tongue cancer and 78% with oral tongue cancer. Organ-sparing surgery was done in 33% base of tongue tumors and 76% oral tongue cancer. Median follow up period was 38,5±30 months.
Purpose/Objective: The standard treatment for oral cancer remains surgery. Nevertheless, patients with gingival cancer treated with surgeries often accept a deteriorated quality of life. Although organ-
Results: Five year PFS was 71% for base of tongue cancer and 52% for oral tongue cancer. In univariate analysis most informative predictors (p <0.05) were gender, alcohol intake, comorbidities - a form of tumor
S24 growth, perineural invasion, p21, COX -2, p53, E cadherin, VEGF, Bcl- 2 and Ki- 67expression. Multi-factorial study showed that the most probable relationship (p less than 0.06 ) with localrecurrence demostrated regular use of alcohol , comorbidities, tumor location , perineural invasion , the expression of proteins - p53, COX- 2 and E cadherin. Based on multivariate statistical analysis of the contribution of clinical, morphological and molecular predictors combined predictive model was developed (including a total of 15 factors). Conclusions: Cancer of the base of tongue is more radiosensitive and promising in terms of the radical conservative treatment. EP-1114 A feasibility study of concurrent cetuximab during induction chemotherapy and IMRT for stage IV head and neck cancer J.C. Lin1, W.Y. Wang2, S.A. Liu3, C.W. Twu3, P.J. Lin1, Y.C. Liu1 1 Taichung Veterans General Hospital, Department of Radiation Oncology, Taichung, Taiwan 2 Hung Kuang University, Department of Nursing, Taichung, Taiwan 3 Taichung Veterans General Hospital, Department of Otorhinolaryngology, Taichung, Taiwan
ESTRO 33, 2014 Acute and late toxicities are reported in table 1. Acute skin toxicity and neck edema were mostly detected in the adjuvant radiotherapy group, while dysphagia G1-2, mucositis G3-4 and dry mouth were mostly registered in RR group. Late skin toxicity and neck edema incidence is higher in the adjuvant radiotherapy group; that of mild laryngeal edema and dry mouth in the RR group. Univariate analysis of survival (log rank test) for all endpoints confirmed the role of T, N and clinical stage as prognostic factors. There was no significant difference in disease free survival (DFS, LRFS, NRFS and MFS) between the different treatment modalities. At multivariate analysis (Cox Regression) nodal involvement at presentation was the only factor useful to predict disease-free survival. 21 pts underwent salvage total laryngectomy: 18 after RR and 3 after SHLR (p=NS) (Figure 1).
Purpose/Objective: To evaluate the feasibility of adding cetuximab during the whole course of induction chemotherapy (IndCT) + intensitymodulated radiotherapy (IMRT) for patients with stage IV squamous cell carcinoma of head and neck (SCCHN). Materials and Methods: The IndCT consists of cisplatin 60 mg/m2, alternating with 5-fluorouracil 2500 mg/m2 plus leucovorin 250 mg/m2 by an outpatient weekly schedule for a total of 10 weeks. IMRT 70 Gy/35 fractions were delivered to the original primary tumor and metastatic nodal region. Cetuximab 400 mg/m2 day 1, then 250 mg/m2 were administered every week during the whole chemoradiotherapy period. Results: Twenty-three patients were recruited. Patient compliance is good. Grade 3/4 toxicity during cetuximab-IndCT phase included leucopenia (0%), anemia (17.4%), thrombocytopenia (8.7%), vomiting (4.3%), mucositis (4.3%) and skin rash (17.4%). Response evaluated after cetuximab-IndCT showed 39.1% complete response, 47.8% partial response, and stable disease 13.1%. After cetuximab-IMRT, we observed 77.3% complete response, 18.2% partial response, and 4.5% stable disease. The major side effects during cetuximab-IMRT phase were 77.3% grade 3/4 mucositis and 45.4% grade 3/4 radiation dermatitis. All 23 patients could finish 10 weekly cetuximab during IndCT smoothly but 17/22 patients completed 7 weekly cetuximab during IMRT. One patient with stable disease after cetuximab-IndCT refused cetuximab-IMRT and shifted to surgery. Conclusions: Concurrent cetuximab, in combination with IndCT-IMRT is feasible with high response rate in patients with stage IV SCCHN. EP-1115 Clinical outcomes and toxicity in supraglottic laryngeal cancer treated with radical or adjuvant radiotherapy S. Pedretti1, L. Costa2, F. Foscarini1, S. Ciccarelli1, G. Pascale1, L. Pegurri2, N. Pasinetti2, S. Tonoli2, M. Buglione1, S.M. Magrini1 1 Brescia University, Radiation Oncology, Brescia, Italy 2 Spedali Civili di Brescia, Radiation Oncology, Brescia, Italy Purpose/Objective: To analyze clinical outcomes, acute and late toxicity, survival and laryngeal preservation, after different treatment for patients with supraglottic laryngeal cancer: radiotherapy alone (RR), radiotherapy after supraglottic horizontal laryngectomy (SHLR) and radiotherapy after total laryngectomy (TLR). Materials and Methods: From 1984 to 2012 708 patients (pts) were treated at Radiation Oncology Department of Spedali Civili - Brescia: 324 with RR, 126 with SHLR and 258 with TLR. 3 pts were excluded from analysis because T4 and subjected to not adequate SHLR. The acute and late toxicity (CTCAE v.4.0) were analyzed and related with radiotherapy purpose (χ2 test). Survival and laryngeal preservation were correlated with other known prognostic factors. Results: pts undergoing RR were older (p= 0.001), had worse PS (p= 0.000) and more comorbidity (p= 0.003) than the others. Pts undergoing TLR had more frequently locally advanced disease (T3-T4 52%) and nodal involvement (N+ 77%) (p=0.000), while pts treated with SHLR had smaller tumors (T2 63%) with cervical adenopathy (71%). 526, 157 and 22 pts had respectively 2D, 3D and IMRT treatment. Only 78 pts had concomitant chemotherapy with weekly CDDP (40mg/m2. RT doses on T and N were significantly higher in pts treated with RR (p= 0.000). The pattern of recurrence analysis showed no significant difference in the incidence of local or nodal recurrence.
Conclusions: In this historical series, radiotherapy, alone or in combination with chemotherapy, provides loco-regional control comparable to combined treatments (both after conservative and demolitive surgery), with no increase in severe late toxicity and allowing larynx preservation.