Comparative study between single modality radiotherapy and concurrent chemoradiation for selected patients with early-stage laryngeal cancer.

Unfavorable T2 glottic squamous cell carcinoma with impaired vocal cord mobility and/or bulky disease has been a real treatment challenge with high local failure rates. The purpose of this study is to compare the oncological outcome of unfavorable T2 glottic carcinoma in patients treated with radical radiotherapy versus concurrent chemoradiation. This study is a prospective, open label, randomized trial, in which all patients with unfavorable T2 glottic cancer were treated with either single modality radiotherapy using hypofractionation protocol 65.25 Gy (arm A) or concurrent chemoradiation (arm B) between 2019 and 2023. The primary end points were local control and local progression free survival (PFS). Sixty-two patients were recruited in the study. Local control was significantly higher in concurrent chemoradiation (CCRT) group compared to radiotherapy (RT) group. The 3-year local progression free survival rates were significantly higher in CCRT arm (85.5%) compared to RT arm (57.8%) (P=0.015). Concurrent chemoradiation should be considered for selected patients with T2 glottic squamous cell carcinoma with impaired vocal cord mobility and/or bulky disease due to high rate of local failure with radiotherapy alone.