Hypofractionated radiotherapy for early glottic cancer: a retrospective interim analysis of a single institution

Abstract

Purpose To evaluate the results of hypofractionated radiotherapy (HFX) for early glottic cancer. Materials and Methods Eighty-five patients with cT1-2N0M0 squamous cell carcinoma of the glottis who had undergone HFX, performed using intensity-modulated radiotherapy (IMRT, n = 66) and three-dimensional conformal radiotherapy (3D CRT, n = 19) were analyzed. For all patients, radiotherapy was administered at 60.75 Gy in 27 fractions. Forty-three patients received a simultaneous integrated boost (SIB) of 2.3–2.5 Gy per tumor fraction. Results The median follow-up duration was 29.9 months (range, 5.5 to 76.5 months). All patients achieved complete remission at a median of 50 days after the end of radiotherapy (range, 14 to 206 days). The 5-year rates for locoregional recurrence-free survival was 88.1%, and the 5-year overall survival rate was 86.2%. T2 stage was a prognostic factor for locoregional recurrence-free survival after radiotherapy (p = 0.002). SIB for the tumor did not affect disease control and survival (p = 0.191 and p = 0.387, respectively). No patients experienced acute or chronic toxicities of ≥grade 3. IMRT significantly decreased the dose administered to the carotid artery as opposed to 3D CRT (V 35 , p < 0.001; V 50 , p < 0.001). conclusions Patients treated with HFX achieved acceptable locoregional disease control rates and overall survival rates compared with previous HFX studies. A fraction size of 2.25 Gy provided good disease control regardless of SIB administration.

Hypofractionated radiotherapy for early stage glottic cancer: efficacy of 3.5 Gy per fraction

“…First, the patient cohort of the current study has a short follow-up period. Although late local recurrence is possible, this early result retains some significance as the cohort has a longer median follow-up period than previously reported median times to local recurrence [3,5,15,30]. Further follow-up is warranted for evaluation of late toxicities.…”

Hypofractionated (2.75 Gy per fraction) versus Conventionally Fractionated Primary Radiotherapy for T2N0M0 Carcinoma of the Glottis

“… 4 Another recent, single-center analysis showed a fraction size of 2.25 Gy provided acceptable disease control rates in this patient population. 5 To date, the majority of the published studies of hypofractionated radiotherapy in early glottis cancer included a mostly T1 patient population treated with < 2.5 Gy per fraction. 6 7 8 9 10 11 12 …”

“…4 Another recent, single-center analysis showed a fraction size of 2.25 Gy provided acceptable disease control rates in this patient population. 5 To date, the majority of the published studies of hypofractionated radiotherapy in early glottis cancer included a mostly T1 patient population treated with < 2.5 Gy per fraction. [6][7][8][9][10][11][12] The primary aim of this study was to analyze the survival outcomes of radical radiotherapy for T2N0M0 carcinoma of the glottis and compare two radiotherapy regimens: fractionated radiotherapy of 63 to 65 Gy in 30 daily fractions (2.10-2.17 Gy per fraction) and hypofractionated radiotherapy of 55 Gy in 20 daily fractions (2.75 Gy per fraction).…”