Results of accelerated radiotherapy for supraglottic carcinoma: A massachusetts general hospital and massachusetts eye and ear infirmary experience

Predictors of radiotherapy outcome in patients with T2 supraglottic carcinoma

“…Single modalities of surgery or radiotherapy are both options for such patients. Despite the advent of voice sparing surgical techniques, radiation therapy is commonly used in the management of early supraglottic carcinomas giving local control ratio in the range of 70-100% [3,5,[8][9][10][11].…”

“…Good nodal response may be attributed to generally early nodal stages (mostly N1) in our patients. Nakfoor et al [11] reported regional control as high as 93% also for N2-3 patients. Despite this, nodal size seems to be an independent factor for achieving complete regional response and for bulky nodal disease exclusive radiotherapy may be not enough.…”

“…In Chan et al [12] study the chance for complete regional [14]. Contrary to more locally advanced stages, for early supraglottic lesions it is postulated that any positive neck node is associated with decrease in the probability of local control [11,15]. Our results confirmed this relationship, and those with initial nodal involvement had over four-fold higher risk of local failure.…”

“…Twice-daily radiation at 1.6 Gy per fraction to a total dose of 67.2-72 Gy in 40-42 days with planned treatment break after 38.4-48 Gy due to acute mucosal toxicity was reported by Nakfoor. They found that accelerated hyperfractionated RT is effective for such group of patients with the exception for T4 tumors and neck disease for whom adjuvant therapy should be considered [11]. Other data also indicate that altered fractionation schedules are particularly efficient in reducing local failures, whereas benefit on nodal control is less pronounced [16].…”

“…Nakfoor et al [11] reported 41% overall surgical salvage rate of all failures and 66% selectively for T2 tumors that gives ultimately 82% 5 yearrelapse-free survival. Mendenhall et al [3] reported over 2 years initial LC for T2 patients of 77% (20/26 pts).…”