{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T06:14:02Z","timestamp":1779257642180,"version":"3.51.4"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Radiotherapy (RT) achieves excellent local control (LC) in early-stage glottic cancer (ESGC); however, treatment-related edema or necrosis may necessitate tracheostomy and adversely affect quality of life. We compared tracheostomy rates and oncologic outcomes between whole-larynx radiotherapy (WLRT) and vocal cord\u2013only radiotherapy (VC-RT) in patients with ESGC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 247 patients with Tis\u2013T2 glottic cancer treated with definitive RT (2007\u20132023) at two Middle Eastern centers. Patients received WLRT (n = 166) or VC-RT (n = 81). The primary endpoint was a tracheostomy rate (TR) \u22656 months after RT for non-recurrent airway compromise. Secondary endpoints included 3-year local failure (LF) and overall survival (OS). TR and LF rates were analyzed using cumulative incidence with death as a competing risk, whereas OS was estimated using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age was 59 years; 97.6% of patients were men and 78.9% were smokers. The median follow-up among surviving patients was 38.2 months (range 1.6\u2013194 months). The median potential follow-up for the entire cohort, estimated by the reverse Kaplan\u2013Meier method, was 45.3 months. VC-RT patients more frequently had cT2 disease (22.2% vs. 5.4%, p &amp;lt; 0.001) and received accelerated fractionation (19.8% vs. 7.2%, p = 0.0069). Overall, 20 of 247 patients (8%) required tracheostomy without recurrence. Edema-related tracheostomy occurred exclusively in WLRT patients (14.2% vs. 0% with VC-RT; p &amp;lt; 0.001). Tracheostomy was reversed in 8\/20 patients (40%) after a median of 13.4 months. The 3-year LF rates were 7.6% with VC-RT and 11.6% with WLRT (p = 0.18), and OS was 93.3% and 89.5% (p = 0.16), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VC-RT reduces the risk of tracheostomy without compromising oncologic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1847970","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:48:30Z","timestamp":1779256110000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Precise radiation, better airway preservation: vocal cord-only image-guided intensity-modulated radiation therapy for early-stage glottic cancer"],"prefix":"10.3389","volume":"16","author":[{"given":"Issa","family":"Mohamad","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, King Hussein Cancer Center","place":["Jordan, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Alotain","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, King Fahad Specialist","place":["Dammam, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shatha","family":"Abu Taha","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, King Hussein Cancer Center","place":["Jordan, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Mukahal","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, King Hussein Cancer Center","place":["Jordan, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayat","family":"Taqash","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, King Hussein Cancer Center","place":["Amman, 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Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renda","family":"AlHabib","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, King Fahad Specialist","place":["Dammam, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akram","family":"Al-Ibraheem","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, King Hussein Cancer Center","place":["Amman, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hikmat","family":"Abdel-Razeq","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Hussein Cancer Center","place":["Amman, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fawzi","family":"Abuhijla","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, King Hussein Cancer Center","place":["Jordan, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramiz","family":"Abu-Hijlih","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, King Hussein Cancer Center","place":["Jordan, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Al Saraireh","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, King Hussein Cancer Center","place":["Amman, Jordan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Hosni","sequence":"additional","affiliation":[{"name":"Radiation Medicine Program, Princess Margaret Cancer Center, University Health network, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17040712","article-title":"Outcome of t2 glottic cancer 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