Top Line: Partial laryngectomy has long been a surgical option for early-stage glottic cancers, so what can’t the same hold true for radiation therapy?
The Study: A retrospective analysis compared partial larynx radiation and whole-larynx radiation for Tis–T2N0M0 laryngeal squamous cell carcinoma among 233 patients treated at MSKCC from 2013–2024. Partial treatment was delivered to the gross tumor with a 5-mm clinical target margin and another 3-mm planning target margin and was selectively offered for tumors confined to a single vocal cord (n=57). Three-year locoregional control was similar: 85% with partial versus 91% with whole larynx treatment. Laryngectomy-free and overall survival rates were excellent either way. Notably, partial larynx radiation reduced acute dysphagia (74% vs 93%) and showed higher early swallowing-related quality-of-life scores—albeit these differences may not be clinically meaningful. In T2 disease, disease control control trended lower with partial treatment (67% vs 85%), suggesting T2 disease does not make for ideal candidacy.
TBL: A more robust prospective randomized trial is worthwhile to confirm partial larynx radiation can offer comparable tumor control with less acute toxicity for select early glottic cancers. | Treechairusame, JAMA Otolaryngol Head Neck Surg 2025
The Study: A retrospective analysis compared partial larynx radiation and whole-larynx radiation for Tis–T2N0M0 laryngeal squamous cell carcinoma among 233 patients treated at MSKCC from 2013–2024. Partial treatment was delivered to the gross tumor with a 5-mm clinical target margin and another 3-mm planning target margin and was selectively offered for tumors confined to a single vocal cord (n=57). Three-year locoregional control was similar: 85% with partial versus 91% with whole larynx treatment. Laryngectomy-free and overall survival rates were excellent either way. Notably, partial larynx radiation reduced acute dysphagia (74% vs 93%) and showed higher early swallowing-related quality-of-life scores—albeit these differences may not be clinically meaningful. In T2 disease, disease control control trended lower with partial treatment (67% vs 85%), suggesting T2 disease does not make for ideal candidacy.
TBL: A more robust prospective randomized trial is worthwhile to confirm partial larynx radiation can offer comparable tumor control with less acute toxicity for select early glottic cancers. | Treechairusame, JAMA Otolaryngol Head Neck Surg 2025