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GLOTTIC CANCER

AN ANALYSIS OF RECURRENCE AS RELATED TO DOSE, TIME, AND FRACTIONATION

J. E. MARKS M.D., L. D. LOWRY M.D., IRVING LERCH PH.D., and M. L. GRIEM M.D.

A sequential analysis of radiation recurrences of early glottic cancer in relation to a gradual increase in dose and NSD showed no significant change in recurrence rates for three 5 year periods, 1955 to 1970.

For NSD levels ranging from 1,700 to greater than 2,000 rets, the probability of control ranged from .75 to .86, indicating that the data were concentrated at the upper end of the dose response curve and that the range of NSDs was not sufficiently great to form the lower and intermediate portions of the suspected curve.

It seems likely from the data that an NSD of 1,900 rets can achieve a probability of control of approximately 0.8.

Our single complication and the data of Stewart and Jackson would indicate that the NSD threshold for laryngeal necrosis approximates 2,050 to 2,240 rets.

Long term follow-up for primarily irradiated glottic cancer is emphasized, since a number of late recurrences were noted and because excellent salvage was obtained by partial or total laryngectomy.


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