Indications for radiotherapy of laryngeal cancer

Laryngeal squamous cell carcinoma is more sensitive to radiotherapy. The advantage of radiotherapy is that it can preserve laryngeal function, especially for early glottic cancer. Of course, radiotherapy for laryngeal cancer must also follow its indications to achieve good results.

1. Glottic cancer: For T1-T2 lesions, which are limited to one or both vocal cords and have not invaded the anterior commissure, arytenoid region or subglottic region, radical radiotherapy should be the first choice. The effect of radiotherapy is equivalent to that of surgical treatment, especially for T1 patients, the 5-year survival rate can reach 90%, and a small number of recurrent patients can also undergo salvage surgery.

2. Supraglottic cancer: T1N0 lesions are limited to the supraglottic area, laryngeal ventricle, and ventricular zone on one side. Radical radiotherapy alone can be performed, but close follow-up observation is required after radiotherapy. If recurrence occurs, surgery should be performed immediately.

3. Glottic cancer and supraglottic cancer: Patients with more extensive cancer can undergo planned preoperative radiotherapy or local radiotherapy, neck dissection of the cervical lymph nodes, and postoperative radiotherapy if there is residual disease after surgery.

4. Laryngeal cancer in the late stage: For patients with T3-T4 lesions that are not suitable for surgical treatment, palliative radiotherapy can be performed to alleviate the condition and prolong the patient's life.

Tips: Staging of glottic laryngeal cancer

T1: The tumor is limited to the vocal cords and may invade the anterior commissure or posterior commissure, and the vocal cords move normally.

T2: The tumor invades the supraglottic area and/or subglottic area, and/or the vocal cord movement is limited.

T3: The tumor is confined to the larynx with fixation of the vocal cords and/or invasion of the paraglottic space, or minimal destruction of the thyroid cartilage.

T4a: The tumor has invaded through the thyroid cartilage and/or has invaded extralaryngeal tissues such as the trachea, soft tissues of the neck including the deep extrinsic tongue muscles, strap muscles, thyroid gland, or esophagus.

T4b: The tumor invades the prevertebral space, surrounds the carotid artery, or invades the mediastinal structures.

Regional lymph nodes

N0: No regional lymph node metastasis