The DAHANCA 6 randomized trial: Effect of 6 vs 5 weekly fractions of radiotherapy in patients with glottic squamous cell carcinoma

Lyhne, Nina Munk; Primdahl, Hanne; Kristensen, Claus Andrup; Andersen, Elo; Johansen, Jørgen; Andersen, Lisbeth Juhler; Evensen, Jan F.; Mortensen, Hanna Rahbek; Overgaard, Jens

doi:10.1016/j.radonc.2015.07.004

Cited by 56 publications

(40 citation statements)

References 36 publications

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“…Surgery was received by 16 patients, fol-K Hier steht eine Anzeige. 1212 (27) 2D-RT two-dimensional conventional radiotherapy, 3D-RT threedimensional conformal radiotherapy, IMRT intensity-modulated radiotherapy, RT radiotherapy, S surgery lowed by adjuvant RT (37% of the cohort with primary surgery). The majority (85%) were treated with 2D/3D-RT rather than IMRT techniques.…”

Section: Resultsmentioning

confidence: 99%

T1–2 glottic cancer treated with radiotherapy and/or surgery

et al. 2017

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Section: Resultsmentioning

confidence: 99%

T1–2 glottic cancer treated with radiotherapy and/or surgery

et al. 2017

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“…The DAHANCA [23, 28] improved 5-year locoregional control rate by 10% using a 6-daily fr/week group (OTT = 39 d) versus the SF 5-daily fr/week group (OTT = 46 d). Those schedules decreased the OTT by 1 week (12 Gy/week), during the whole course of therapy, yielding a 10% increase in the 5-year locoregional control rate, with good early and late tolerance (Table 2) [23, 28]. HF with commonly used regimens of 80.5–81.6 Gy given in 1.15–1.2 Gy/fr BID with a 6-h interval, over the conventional 7 weeks, also provided a 10% improvement in locoregional control [1], owing to the total dose escalation.…”

Section: Discussionmentioning

confidence: 99%

“…To secure such a response, the tumor needs to have a functional mechanism capable of regeneration, which is most likely to happen in well-differentiated tumors. Furthermore, the reaction might be controlled by signaling from the surrounding normal mucosa, and the response is, therefore, seen only in the T-site and not the nodal metastases [23, 28]. …”

Section: Discussionmentioning

confidence: 99%

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Radiotherapy for laryngeal cancer—technical aspects and alternate fractionation

Yamazaki

Suzuki

Nakamura

et al. 2017

Journal of Radiation Research

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Early laryngeal, especially glottic, cancer is a good candidate for radiotherapy because obvious early symptoms (e.g. hoarseness) make earlier treatment possible and with highly successful localized control. This type of cancer is also a good model for exploring the basic principles of radiation oncology and several key findings (e.g. dose, fractionation, field size, patient fixation, and overall treatment time) have been noted. For example, unintended poor outcomes have been reported during transition from 60Cobalt to linear accelerator installation in the 1960s, with usage of higher energy photons causing poor dose distribution. In addition, shell fixation made precise dose delivery possible, but simultaneously elevated toxicity if a larger treatment field was necessary. Of particular interest to the radiation therapy community was altered fractionation gain as a way to improve local tumor control and survival rate. Unfortunately, this interest ceased with advancements in chemotherapeutic agents because alternate fractionation could not improve outcomes in chemoradiotherapy settings. At present, no form of acceleration can potentially compensate fully for the lack of concurrent chemotherapy. In addition, the substantial workload associated with this technique made it difficult to add extra fractionation routinely in busy clinical hospitals. Hypofractionation, on the other hand, uses a larger single fractionation dose (2–3 Gy), making it a reasonable and attractive option for T1–T2 early glottic cancer because it can improve local control without the additional workload. Recently, Japan Clinical Oncology Group study 0701 reprised its role in early T1–T2 glottic cancer research, demonstrating that this strategy could be an optional standard therapy. Herein, we review radiotherapy history from 60Cobalt to modern linear accelerator, with special focus on the role of alternate fractionation.

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“…For patients with head and neck squamous cell cancers (HNSCC), synchronous SPC has been reported in 1–6% and metachronous (subsequent) SPC in 20–30% 3 4…”

Section: Introductionmentioning

confidence: 99%

Four synchronous cancers in a patient with tongue pain as the only symptom

et al. 2016

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Synchronous carcinomas may be present in up to 6% of patients with head and neck squamous cell carcinoma (HNSCC) and thus may represent a significant factor in the disease burden. This case report illustrates the importance of a thorough examination of these patients. This patient presented with three synchronous squamous cell carcinomas, two in the tongue and one in the aryepiglottic fold. Positron emission tomography CT (PET-CT) was required for the detection of the carcinomas as the initial MRI and CT scans were inconclusive due to artefacts. Furthermore, PET-CT also revealed increased metabolic activity in the lymph nodes of the neck, which subsequently led to detection of a low-grade follicular lymphoma in addition to the squamous cell carcinomas. These findings support a generous use of PET-CT in patients with HNSCC, at least in those with obvious risk factors.

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The DAHANCA 6 randomized trial: Effect of 6 vs 5 weekly fractions of radiotherapy in patients with glottic squamous cell carcinoma

Cited by 56 publications

References 36 publications

T1–2 glottic cancer treated with radiotherapy and/or surgery

T1–2 glottic cancer treated with radiotherapy and/or surgery

Radiotherapy for laryngeal cancer—technical aspects and alternate fractionation

Four synchronous cancers in a patient with tongue pain as the only symptom

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