Comparison of Three Fractionation Schedules in Radiotherapy for Early Glottic Squamous Cell Carcinoma

Suzuki, Gen; Yamazaki, Hideya; Aibe, Norihiro; Masui, Koji; Shimizu, Daisuke; Kimoto, Tsunenobu; Nishimura, Takeshi; Kawabata, Kanako; Nagasawa, Shinsuke; Machida, Kazutaka; Yoshino, Yuki; Watanabe, Sho; Sugiyama, Yoichiro; Arai, Akihito; Hirano, Shigeru; Yamada, Kazuo

doi:10.21873/invivo.12101

Cited by 4 publications

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 5-year OS in the CF and HF groups were 84.9% and 72.1%, respectively (p = 0.99). Our finding is consistent with those reported in many studies of no impact of HF schedule on survival outcome [ 13 , 15 , 17 , 25 ].…”

Section: Discussionsupporting

confidence: 93%

The outcome of early-stage glottic carcinoma patients treated with radiotherapy: Egyptian National Cancer Institute (NCI-Egypt) experience

Mohamed,

Hassouna,

Mosalum

et al. 2023

Rep Pract Oncol Radiother.

View full text Add to dashboard Cite

Background Radiotherapy (RT) is an appropriate treatment option for early-stage glottic cancer (ESGC) that achieves high local control and preserves voice quality. However, the optimal radiation treatment schedule remains unknown. We present our institution’s 14-year experience in treating ESGC with definitive radiotherapy between 2005 and 2019 inclusively. Materials and methods We reviewed the medical records of 104 patients; 63 (60.5%) were treated with conventional fractionation (CF), and 41 (39.5%) were treated with hypofractionated radiotherapy (HF). The clinical T-stage was T1a in 50 patients (48%), T1b in 27 (26%), and T2 in 27 (26%). Age, gender, anterior commissure involvement, stage, radiotherapy technique, radiation fraction size, and overall treatment time (OTT) were analyzed as prognostic factors. The survival outcomes, local regional control (LRC), and laryngeal preservation rate were evaluated. Results The 5-year overall survival (OS) and LCR were 83.3% and 78%, respectively. On univariate analysis, treatment with CF (p = 0.02), prolonged OTT > 49 days in CF and > 40 days in HF (p = 0.04), and RT total dose < 66 Gy (p = 0.03) were associated with poor LRC. Multivariate analysis showed a non-significant association with LRC (all p > 0.05). The 5-year OS rate in the CF and HF-treated patients was 84.9% and 72.1%, respectively (p = 0.99), and in patients who had T1a, T1b, and T2 disease, were 78.2%, 96.0%, and 82.1%, respectively (p = 0.43). All patients and tumor variables showed no statistically significant association with OS. Only low-grade acute toxicity was observed. Conclusion Non-inferiority results supported the HF schedule to ESGC, including high local disease control and decreased overall treatment time. Our study supports its efficacy in the primary care of ESGC with manageable side effects.

show abstract

Section: Discussionsupporting

confidence: 93%

The outcome of early-stage glottic carcinoma patients treated with radiotherapy: Egyptian National Cancer Institute (NCI-Egypt) experience

Mohamed,

Hassouna,

Mosalum

et al. 2023

Rep Pract Oncol Radiother.

View full text Add to dashboard Cite

show abstract

“…Accelerated hyperfractionation may cause relatively severe acute toxicity such as mucositis [35,36], although several reports have suggested the benefit of accelerated hyperfractionation for EGSCCs [37,38]. In our study, the total dose of hyperfractionated radiotherapy (74.4 Gy/62 fractions) was slightly smaller and resulted in excellent LC and minimum toxicities.…”

Section: Discussionmentioning

confidence: 54%

Targeting Anterior Commissure Involvement with Hyperfractionated Radiotherapy for T1–T2 Squamous Cell Carcinoma of the Glottic Larynx

Seno,

Iwashita,

Kajiwara

et al. 2024

Cancers

View full text Add to dashboard Cite

Anterior commissure is involved in about 20% of early-stage glottic squamous cell carcinomas (EGSCCs). Treatment outcomes and prognostic factors for EGSCC with anterior commissure involvement (ACI) were evaluated by focusing on hyperfractionated radiotherapy (74.4 Gy in 62 fractions). One-hundred and fifty-three patients with T1–T2 EGSCC were included in this study. The median total doses for T1a, T1b, and T2 were 66, 74.4, and 74.4 Gy, respectively. Overall, 49 (32%) patients had T1a, 38 (25%) had T1b, and 66 (43%) had T2 disease. The median treatment duration was 46 days. The median follow-up duration was 5.1 years. The 10-year overall and cause-specific survival rates were 72% and 97%, respectively. The 10-year local control rates were 94% for T1a, 88% for T1b, and 81% for T2 disease. Local control rates in patients with ACI were slightly better than those in patients without ACI with T1a and T1b diseases; however, the difference was not significant. The 10-year laryngeal preservation rate was 96%. Six patients experienced grade 3 mucositis, and four patients had grade 3 dermatitis. Hyperfractionated radiotherapy was effective for T1 disease with ACI, but insufficient for T2 disease with ACI. Our treatment strategy resulted in excellent laryngeal preservation.

show abstract

“…With the introduction of 3D-conformal and intensity modulated radiotherapy (IMRT), dose distributions improved and organ-at-risk (OAR) dose decreased [ 13 ]. With this improvement in dose distributions, hypofractionated radiotherapy was possible and found to be equally effective or maybe even better in terms of oncological outcome [ 14 ]. Improved diagnostic imaging and the possibility of image-guided radiotherapy (IGRT) opened up the way to rethink target definition for early-stage glottic laryngeal squamous cell carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Oncological outcome of vocal cord-only radiotherapy for cT1-T2 glottic laryngeal squamous cell carcinoma

Ridder

Rijken

Smits

et al. 2023

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Purpose Early-stage glottic cancer can be treated with radiotherapy only. Modern radiotherapy solutions allow for individualized dose distributions, hypofractionation and sparing of organs at risk. The target volume used to be the entire voice box. This series describe the oncological outcome and toxicity of individualized vocal cord-only hypofractionated radiotherapy for early stage (cT1a-T2 N0). Methods Retrospective cohort study with patients treated in a single center between 2014 and 2020. Results A total of 93 patients were included. Local control rate was 100% for cT1a, 97% for cT1b and 77% for cT2. Risk factor for local recurrence was smoking during radiotherapy. Laryngectomy-free survival was 90% at 5 years. Grade III or higher late toxicity was 3.7%. Conclusion Vocal cord-only hypofractionated radiotherapy appears to be oncologically safe in early-stage glottic cancer. Modern, image-guided radiotherapy led to comparable results as historical series with very limited late toxicity.

show abstract

Comparison of Three Fractionation Schedules in Radiotherapy for Early Glottic Squamous Cell Carcinoma

Cited by 4 publications

References 22 publications

The outcome of early-stage glottic carcinoma patients treated with radiotherapy: Egyptian National Cancer Institute (NCI-Egypt) experience

The outcome of early-stage glottic carcinoma patients treated with radiotherapy: Egyptian National Cancer Institute (NCI-Egypt) experience

Targeting Anterior Commissure Involvement with Hyperfractionated Radiotherapy for T1–T2 Squamous Cell Carcinoma of the Glottic Larynx

Oncological outcome of vocal cord-only radiotherapy for cT1-T2 glottic laryngeal squamous cell carcinoma

Contact Info

Product

Resources

About