Radiotherapy for T1‐2N0 glottic cancer: a multivariate analysis of predictive factors for the long‐term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients

Objectives To evaluate the outcomes of patients with early stage glottic cancer ( GC ) treated with radiotherapy ( RT ). Design, setting and participants The current study report on a retrospective analysis of oncologic outcome of 1050 patients with T 1‐2 N 0 glottic cancer treated with radiotherapy. Prospective assessment of quality of life ( Q o L ) and voice handicap index ( VHI ) was performed in all patients treated from 2006 onwards ( n = 233). Main outcome measures Local control ( LC ), regional control ( RC ), disease‐free survival ( DFS ), overall survival ( OS ), quality of life and voice handicap index. Results After a median follow‐up of 90 months (range 3–309), the actuarial rates of local control, regional control, disease‐free survival and overall survival were 85%, 99%, 84% and 81% at 5 years and 82%, 98%, 80% and 61% at 10 years, respectively. On multivariate analysis, T 2 tumours, smoking after radiotherapy and conventional radiation scheme correlated significantly with poor local control. Patients who continued smoking after radiotherapy had also significantly lower overall survival rates ( OR 4.3, P < 0.001). Hypothyroidism was reported in 18% of patients. Slight and temporary deterioration of quality of life scores was reported. Patient‐reported xerostomia and dysphagia at 48 months were −7.1 and −6.5, compared with baseline, respectively. Voice handicap index improved significantly from 37 at baseline to 18 at 48 months. Patients with T 2b and those who continued smoking had significantly worse voice handicap index. Conclusions In the current study, excellent outcome with good quality of life and voice handicap index scores were reported. T 2 tumours, in particular T 2b, and continuing smoking after radiotherapy correlated significantly with poor local control and worse voice handicap index.