Clin Exp Otorhinolaryngol.  2012 Jun;5(2):94-100. 10.3342/ceo.2012.5.2.94.

Definitive Radiation Therapy for Early Glottic Cancer: Experience of Two Fractionation Schedules

Affiliations
  • 1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ahnyc@skku.edu
  • 2Department of Radiation Oncology, Samsung Kangbuk Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract


OBJECTIVES
The authors would report the results of definitive radiation therapy (RT) for early glottic cancer by two different radiation dose schedules.
METHODS
From February of 1995 till June of 2008, 157 patients with T1-2N0 glottic cancer were treated with curative RT at Samsung Medical Center. All patients had squamous cell carcinoma, and there were 89 patients (56.7%) with T1a, 36 (22.9%) with T1b, and 32 (20.4%) with T2. Two different radiation dose schedules were used: 70 Gy in 35 fractions to 64 patients (40.8%, group A); and 67.5 Gy in 30 fractions to 93 patients (59.2%, group B). The median treatment durations were 50 days (range, 44 to 59 days) and 44 days (range, 40 to 67 days) in the groups A and B, respectively.
RESULTS
The median follow-up durations were 85 and 45 months for the groups A and B. No severe late complication of RTOG grade 3 or higher was observed, and there was no difference in acute or chronic complication between the groups. Twenty-four patients experienced treatment failure: local recurrence only in 19 patients; regional recurrence only in one; combined local and regional recurrence in four; and systemic metastasis in none. The overall 5-year disease-free survival and disease-specific survival rates were 84.7% and 94.8%. The disease-free survival rate in the group B was better (78.3% vs. 90.8%, P=0.031). This difference was significant only in T1 stage (83.4% vs. 94.6%, P=0.025), but not in T2 (62.7% vs. 60.6%, P=0.965). Univariate analysis showed that the tumor extent, cord mobility, T-stage, and the dose schedule had significant influence on the disease-free survival, and multivariate analysis showed that only the tumor extent and the dose schedule were associated with the disease-free survival.
CONCLUSION
Superior disease-free survival could be achieved by 2.25 Gy per fraction without increased toxicity over shorter RT duration, when compared with 2.0 Gy per fraction.

Keyword

Laryngeal neoplasms; Radiotherapy; Dose fractionation

MeSH Terms

Appointments and Schedules
Carcinoma, Squamous Cell
Disease-Free Survival
Dose Fractionation
Follow-Up Studies
Humans
Laryngeal Neoplasms
Multivariate Analysis
Neoplasm Metastasis
Recurrence
Survival Rate

Figure

  • Fig. 1 Disease-free survival (A), overall survival (B), and disease-specific survival (C) of the patients with early glottic cancer treated by definitive radiation therapy.

  • Fig. 2 Impact of fraction size by T-stage: disease-free survival rates at 5 years were 83.4% and 94.6% in the groups A and B of T1 patients (P=0.025) (A), and 62.7% and 60.6% in the groups A and B of T2 patients (P=0.965), respectively (B).


Cited by  1 articles

Long-Term Outcome of Definitive Radiotherapy for Early Glottic Cancer: Prognostic Factors and Patterns of Local Failure
Yu Jin Lim, Hong-Gyun Wu, Tack-Kyun Kwon, J. Hun Hah, Myung-Whun Sung, Kwang Hyun Kim, Charn Il Park
Cancer Res Treat. 2015;47(4):862-870.    doi: 10.4143/crt.2014.203.


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