A 55-year-old smoker presents with a T1a glottic carcinoma (confined to one vocal cord with normal mobility). What is the preferred treatment option with equal cure rates but better voice preservation?
- A Radiotherapy alone ✓
- B Total laryngectomy
- C Concurrent chemoradiation
- D Vertical partial laryngectomy (hemilaryngectomy)
Correct answer: A. Radiotherapy alone
Explanation
T1a glottic carcinoma (confined to one cord, normal mobility) has a 5-year cure rate of approximately 90-95% with either radiotherapy or transoral laser microsurgery/partial laryngectomy. However, radiotherapy generally provides superior voice quality outcomes compared to surgery for T1a lesions. Concurrent chemoradiation is not indicated for early T1 lesions due to excessive toxicity without benefit. Total laryngectomy is reserved for advanced cases.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.