Patients allocated to radiation therapy had their treatments
started within 6 weeks after randomization. The larynx was
irradiated with 6-MeV photons from 2 opposing 4.5 4.5
to 5 5 cm wedge fields to a total cumulative dose of
66 Gy in 2-Gy daily fractions over 6.5 weeks with a linear
accelerator. When necessary an anterior bolus was added to
achieve the desired dose at the anterior commissure. The
uniformity criteria within the planned target volume were
defined according to the International Commission on Radiation
Units and Measurements Report 50 (7). The clinical
target volume encompassed the larynx with no attempt to
irradiate the regional lymphatics.
Patients assigned to TLS had the tumor excised under
general anesthesia within 6 weeks from randomization by