How would you treat an elderly patient with T1 glottic laryngeal cancer who refuses 28 fractions?

I would suggest using 52 Gy in 16 fractions. This is NCCN-supported for T1 glottic lesions and has a long track record of success and tolerability (Gowda et al., PMID 12972304). I have used this regimen exclusively with VMAT. That said, it predates IMRT and 3-D conformal is very reasonable. I would ...