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May 14, 1982

Treatment of Cancer of the Larynx-Reply

Author Affiliations

Southern California Permanente Medical Group Los Angeles

JAMA. 1982;247(18):2498. doi:10.1001/jama.1982.03320430022014

In Reply.—  I believe that irradiation is the method of choice for T1 and T2 carcinomas of the vocal cord. The cure with radiation alone is in excess of 85% with present-day treatment techniques and increases in excess of 95% with surgical salvage.1 I think that the quality of a patient's voice after radiation for invasive cancer is superior to that of partial laryngeal surgery. I would presume that, as with most historical series, neither adequate dose nor proper portal placement was used in many of this author's 147 patients.We are in agreement with Dr Miller that carcinoma in situ is best managed by surgery, but we have shown that irradiation can also be highly successful.2Legitimate differences of opinion exist in many aspects of the management of head and neck tumors.3 Exchange of views such as this is of educational interest to physicians, which always