MRCP2-3674

MRCP2-3674

A 57-year-old male rock band singer presents with a two-month history of hoarseness and painful swallowing that did not improve with three weeks of antibiotics. The patient has a long history of smoking, with a total of 65 packs per year.

During the physical examination, the patient’s vital signs, including temperature, were normal. There was no cervical lymphadenopathy, and the oropharynx appeared normal upon inspection. No masses were palpated, and the rest of the examination was unremarkable.

An endoscopic examination revealed a 2 cm ulcerated lesion protruding from the right vocal cord. The lesion was friable and caused some bleeding. A biopsy of the vocal cord lesion confirmed the presence of squamous cell carcinoma. A CT scan of the neck and chest showed no signs of metastatic disease, and a positron emission tomographic scan was normal.

The patient expressed a desire to maintain his ability to speak and was willing to quit smoking immediately. What is the most appropriate next step in treatment?