T1N0/T2N0 glottic carcinoma: A comparison of two fractionation schedules

Authors: Short; Krawitz; Macann; West; Morton; McIvor; Chaplin; Simcock; Gathercole; Dorman; Hindley

Source: Australasian Radiology, Volume 50, Number 2, April 2006 , pp. 152-157(6)

Publisher: Blackwell Publishing

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Abstract:

Summary

The aim of this paper is the retrospective comparison of accelerated/hypofractionated radiotherapy regimen (AHFX) with standard fractionation regimen (SFX) for patients with early glottic carcinoma. One hundred and forty-five patients with T1–T2 glottic cancer between 1986 and 1998 were eligible. Before 1992, patients received 60–66 Gy in 30–33 fractions over 6–6.5 weeks (SFX) with 60Co and 6-MV beams. After 1992, patients received 52.5–55 Gy in 20 fractions over 4 weeks (AHFX) using 6-MV beams. The end-points were overall survival, laryngectomy-free survival (LFS), loco-regional control and toxicity. One hundred and two were stage T1N0; 43 were stage T2N0. Median follow up was 4.9 years. The 5-year overall survival was 78%. Five-year loco-regional control in T1N0 patients was higher in AHFX than in SFX group (95 vs 75%, P = 0.002). Loco-regional control in T2N0 patients was similar for AHFX and SFX (81 vs 80%, P = 0.813). Overall LFS was 88%. T1N0 AHFX patients had 5-year LFS of 95% compared with 75% for SFX (P = 0.003). For T2N0 AHFX patients, overall LFS was 92% compared with 80% for the SFX group (P = 0.291). No grade 4 or 5 late toxicity occurred. One AHFX patient developed grade 3 toxicity; two of 51 SFX patients developed grade 2 toxicity versus five of 94 AHFX patients. AHFX using 6-MV beams for treatment of early glottic cancer resulted in equivalent LFS and toxicity when compared with SFX.

Keywords: dose fractionation; glottis; laryngeal neoplasm; laryngectomy; radiotherapy

Document Type: Research article

DOI: 10.1111/j.1440-1673.2006.01559.x

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