Hypofractionated radiotherapy versus conventional radiotherapy in early glottic cancer T1-2N0M0

Abstract

Objective: Glottic cancer has an excellent probability of cure. The early glottic cancer is usually treated by radiotherapy with different fractionation schedules. The aim of this study was to compare conventional versus hypofractionated radiotherapy with respect to overall survival and disease-free survival. Materials and Methods: A total of fifty patients with T1-2N0M0 glottic cancer with no previous treatment history were prospectively randomized into two arms. In Arm A (Study), patients received a total of 55 Gy in 20# at 2.75 Gy/#, 5 days a week. In Arm B (Control), patients received a total of 66 Gy in 33# at 2 Gy/#, 5 days a week. Disease response was evaluated by the WHO criteria at the end of treatment, then at 1, 2, and 3 months to complete their 6-month follow-up. Overall survival and disease-free survival were evaluated at 1, 2, and 3 years. Results: Overall, 100% of patients in the study arm and 96% of patients in the control arm had complete response after 6 months. Overall survival rates at 1, 2, and 3 years were 96%, 96%, and 88%, respectively, in the study arm, while in the control arm, these values were 92%, 84%, and 80%, respectively, and the difference was not statistically significant (P > 0.05). Disease-free survival at 3 years was 88% in the study arm and 80% in the control arm. Conclusion: The study suggests that hypofractionated regimen may be better in local control and symptomatic relief with the added advantage of shorter treatment time, which offers better patient compliance and advantageous in busy setups where there is heavy patient load.

Overview of glottic laryngeal cancer treatment recommendation changes in the NCCN guidelines from 2011 to 2022

“…The PubMed database search yielded a total of 260 studies (Table A1), of which 68 (26 MAs, 24 RCTs, and 18 SRs) fulfilled the selection criteria 9,13–15,29–31,33,35–94 . The countries in which the largest numbers of studies were performed were China ( n = 18), the United Kingdom ( n = 6), and Italy ( n = 5; Figure 1).…”

“…The main characteristics of the included publications are summarized in Table 3. The treatment of early‐stage glottic cancer, was examined in 44 studies, 29–31,35–38,40,41,45,46,48,50–59,62,64,65,71,72,74–77,79–82,89–94 mainly with transoral laser microsurgery and RT modalities (Figure 2).…”

“…The PubMed database search yielded a total of 260 studies (Table A1 ), of which 68 (26 MAs, 24 RCTs, and 18 SRs) fulfilled the selection criteria. 9 , 13 , 14 , 15 , 29 , 30 , 31 , 33 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , ...…”

“…The main characteristics of the included publications are summarized in Table 3 . The treatment of early‐stage glottic cancer, was examined in 44 studies, 29 , 30 , 31 , 35 , 36 , 37 , 38 , 40 , 41 , 45 , 46 , 48 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 62 , 64 , 65 , 71 , 72 , 74 , 75 , 76 , 77 , 79 , 80 , 81 , 82 , 89 , 90 , 91 , 92 , 93 , 94 mainly with transoral laser microsurgery and RT modalities (Figure 2 ).…”

Cost-effectiveness of hypofractionated versus conventional fractionated radiotherapy for the treatment of men with early glottic cancer: a study in the Brazilian public and private health system

“…After a systematic literature search on the PubMed database to find randomized clinical trials that compared HYPOFRT and CFRT (search strategies are described in Supplementary Table 3 ). Two randomized clinical trials compared HYPORFR and CFRT for early-stage glottic cancer [ 8 , 28 ]. The landmark Japanese trial was chosen to provide the transition probabilities due to the higher sample size [ 8 ].…”