Hypofractionated Radiotherapy in the Treatment of Early Glottic Carcinoma

Abstract

Introduction: Given the high probability of cure, the aims of treatment are cure, laryngeal preservation and good voice quality while making effective use of available resources. In this study we analyze locoregional control (LRC) and survival following hypofractionated radiotherapy in early stage glottic squamous cell carcinoma treated at patients with early glottic squamous cell carcinoma were treated with hypofractionated radiotherapy. All patients were included in the study (M: 94%; F:6%). Median age was 60 years (range: 21-81 years). Sixty-six percent of patients were smokers. AJCC stage was T1 in 95% and T2 in 5% of the patients. Radiotherapy dose was 55 Gy in 20 fractions over 4 weeks. All patients were treated on cobalt-60. Median radiotherapy treatment time was 28 days (range: 23-35 days). Results:The LRC rate after primary radiotherapy at 5 years was 91% (95% CI: 88-94%). The 5 years overall and disease-specific survival was 86% (95% CI: 81 and 91%) and 97% (CI 95%: 95 and 99%) respectively. Patients with T1a and T1b disease had LRC rates of 95 and 88% (p = 0.32). The LRC rates for patients with and without anterior commissure involvement at 5 years were 80 and 96% (p = 0.02) respectively.Conclusion: Hypofractionated radiotherapy 55 Gy in 20 fractions is comparable to conventional fractionation schedules in terms of locoregional control and survival while offering potential for optimizing resources usage.

Hypofractionated accelerated radiotherapy in T1–3 N0 cancer of the larynx: A prospective cohort study with historical controls

“…11,35 In published reports number of patients treated with hypofractionated RT was limited and authors suggested a need for further research. 10,12,18,35 The group with hypofractionated RT reported in this paper is one of the largest published so far. More rigorous prospective studies could be considered to compare fractionation and timing of RT in the larynx and other head and neck patients and to provide stronger evidence, but published results quite consistently demonstrate that RT using fraction dose of 2.25-2.5 Gy delivered 5 days per week up to a total dose of 52-65 Gy gives the same or even better locoregional control than standard RT.…”

“…8 Results similar to standard RT fractionation or better have been obtained with hypofractionated protocols. 3,[9][10][11][12][13] Both methods of altered fractionation have been shown to offer some advantages. Standard, accelerated, hyper-and hypofractionated regimes are used in clinical practice.…”

Survival Outcomes in Early Glottic Carcinoma; A Single Institution Experience

“…[11,12] A study published in 2011 in International Journal of Head and Neck Surgery showed 5-year overall survival (OS) of 86%. [13] Those patients were followed for another 5 years, and here, we report our 10-year experience of treating T1 and T2 glottic carcinoma with 55 Gy in 20 fractions over a period of 4 weeks.…”