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Purpose The purpose of this study was to compare the treatment outcomes of definitive radiotherapy (RT) with cordectomy in patients with early glottic cancer. Materials and methods A total of 165 patients who were diagnosedwith T1/2 squamous cell carcinoma of the glottic larynx between January 2006 and December 2012 were retrospectively analyzed. A total of 112 patients received RT and 53 patients received cordectomy. Local control (LC), disease-free survival (DFS), overall survival (OS), and larynx preservation rates after RT and cordectomy were investigated. Results The median follow-up period was 77.7 months (range, 10.7 to 127.0 months). The 3- and 5-year LC rates were 91.9% and 89.9%, respectively, for the RT group, and 82.8% and 73.2%, respectively, for the cordectomy group (p=0.006). The 3- and 5-year DFS rates were 87.5% and 83.7%, respectively, for the RT group and 79.2% and 68.0%, respectively, for the cordectomy group (p=0.046). No significant differences were identified in the 5-year OS (92.8% vs. 90.6%, p=0.713) or larynx preservation rates (98.2% vs. 97.2%, p=0.831) between groups. The major failure pattern was local failure (n=26), followed by regional (n=3) and distant failure (n=2). Multivariate analysis of LC showed that T2 stage (p=0.012) and receiving cordectomy as initial treatment (p=0.001) were significantly associated with poorer LC. Conclusion RT resulted in higher rates of LC and DFS compared to cordectomy for early glottic cancer. Treatment with radiotherapy is feasible and should be encouraged for both T1 and T2 glottic cancer.

Purpose The purpose of this study was to evaluate the clinical outcomes of patients treated with radiotherapy (RT) for a carcinoma of the external auditory canal (EAC) and middle ear. Materials and methods The records of 32 patients who received RT from 1990 to 2013 were reviewed retrospectively. The Pittsburgh classification was used to stage all the cancers (early stage, T1/T2 [n=12]; advanced stage, T3/T4 or N positive [n=20]). Twenty-one patients (65.6%) were treated with postoperative RT and 11 patients (34.4%) were treated with definitive RT. The median radiation doses for postoperative and definitive RT were 60 Gy and 64.8 Gy, respectively. Chemotherapy was administered to seven patients (21.9%). Results The 5-year overall survival and disease-free survival rates for all patients were 57% and 52%, respectively. The disease control rates for the patients with early stage versus advanced stage carcinomawere 55.6% (5/9) and 50% (6/12) in the postoperative RT group and 66.7% (2/3) and 37.5% (3/8) in the definitive RT group, respectively. Overall, 15 cases (14 patients, 46.7%) experienced treatment failure; these failures were classified as local in four cases, regional in one case, and distant in 10 cases. The median follow-up period after RT was 51 months (range, 7 to 286 months). Conclusion Patients with early stage carcinoma achieved better outcomes when definitive RT was used. Advanced stage carcinoma patients experienced better outcomes with postoperative RT. The high rate of distant failure after RT, with or without surgery, reflected the lack of a consensus regarding the best therapeutic approach for treating carcinoma of the EAC and middle ear.

Purpose The purpose of this study is to compare the treatment outcomes for locally advanced resectable hypopharyngeal cancer between organ-preserving chemoradiotherapy (CRT) and surgery followed by radiotherapy (SRT). Materials and Methods We reviewed 91 patients with stage III/IV hypopharyngeal squamous cell carcinoma treated with radiotherapy (RT). In the CRT group (n=34), 18 patients were treated with concurrent CRT and 16 patients with induction chemotherapy plus concurrent CRT. In the SRT group (n=57), six patients were treated with total laryngopharyngectomy, 34 patients with total laryngectomy (TL) and partial pharyngectomy (PP), and 17 patients with PP, which were followed by adjuvant radiotherapy (n=41) or CRT (n=16). The median RT dose was 70 Gy for CRT and 59.4 Gy for SRT. Results Five-year local control (84.1% vs. 90.9%), and disease-free survival (DFS, 51.0% vs. 52.7%) and overall survival (OS, 58.6% vs. 56.6%) showed no significant difference between the CRT and SRT groups. The functional larynx-preservation rate was higher in the CRT group (88.2% vs. 29.8%). Treatment-related toxicity, requiring surgical intervention, occurred more frequently in the SRT group (37% vs. 12%). In the SRT group, TL resulted in a significantly higher DFS than larynx-sparing surgery (63.9% vs. 26.5%, p=0.027). Treatment outcome of the SRT group improved when only patients with TL were considered (n=40); however, 5-year OS (67.1% vs. 58.6%, p=0.830) and DFS (63.9% vs. 51.0%, p=0.490) did not improve significantly when compared to the CRT group. Conclusion Organ preserving CRT provided a treatment outcome that is comparable to SRT for locally advanced hypopharyngeal cancer, while offering an opportunity for functional larynx-preservation and reduced treatment-related toxicity.