Background
Retrospective single-institution study. T1N0M0 glottic larynx cancer treated with IMRT vs 3D conformal RT (3D-CRT). Tested whether IMRT reduces dose to arytenoid cartilage and contralateral vocal cord while maintaining local control, potentially improving voice outcomes.
Interventions and follow up
Arm A: IMRT for T1 glottic larynx cancer
Arm B: 3D-CRT for T1 glottic larynx cancer
Primary endpoint: Voice quality (perceptual and acoustic) and local control
mFollow up: NR
Arm B: 3D-CRT for T1 glottic larynx cancer
Primary endpoint: Voice quality (perceptual and acoustic) and local control
mFollow up: NR
Results
Dose to OARs: IMRT achieved comparable or improved dose reduction to arytenoid and contralateral structures vs 3D-CRT
Local control: Maintained, not compromised by IMRT
Voice: Potential voice-quality benefit with IMRT-based planning (quantitative figures NR in source)
Local control: Maintained, not compromised by IMRT
Voice: Potential voice-quality benefit with IMRT-based planning (quantitative figures NR in source)
Adverse events
Acute toxicity: Comparable between techniques
Grading: Retrospective; toxicities not formally graded
Grading: Retrospective; toxicities not formally graded
Conclusions
IMRT for T1 glottic larynx cancer can reduce dose to adjacent critical structures (arytenoids, contralateral vocal cord) vs 3D-CRT while maintaining excellent local control, potentially improving functional voice outcomes.
Key Limitations
Single-institution retrospective; small sample; voice outcomes a surrogate for patient benefit; follow-up not specified; selection bias and dosimetric (not clinical endpoint) focus limit generalizability.
Clinical Context
3D-CRT (small lateral fields, ~63-66 Gy) remains a standard for T1 glottic cancer. IMRT use is debated for early glottic disease given small target and toxicity tradeoffs; this study supports IMRT for OAR sparing in selected cases pursuing voice preservation.