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TN/TN glottic carcinoma: a comparison of two fractionation schedules
1Department of Radiation Oncology, Auckland District Health Board, Auckland, New Zealand. susan.short@xtra.co.nz
Australasian Radiology
|April 26, 2006
Summary
Accelerated/hypofractionated radiotherapy (AHFX) showed improved loco-regional control for early glottic cancer (T1N0) compared to standard fractionation (SFX). Both regimens demonstrated similar overall survival and toxicity profiles in this retrospective study.
Area of Science:
- Radiation Oncology
- Head and Neck Cancer Treatment
- Clinical Outcomes Research
Background:
- Early glottic carcinoma treatment traditionally involves standard fractionation radiotherapy (SFX).
- Accelerated/hypofractionated radiotherapy (AHFX) offers a potentially more efficient treatment schedule.
- Comparing AHFX with SFX is crucial for optimizing early glottic cancer management.
Purpose of the Study:
- To retrospectively compare the efficacy and toxicity of accelerated/hypofractionated radiotherapy (AHFX) versus standard fractionation radiotherapy (SFX).
- To evaluate outcomes including overall survival, laryngectomy-free survival (LFS), and loco-regional control in patients with early glottic carcinoma.
- To assess treatment-related toxicity between the two radiotherapy fractionation regimens.
Main Methods:
- Retrospective analysis of 145 patients with T1-T2 glottic cancer treated between 1986 and 1998.
- Patients received either SFX (60-66 Gy in 30-33 fractions over 6-6.5 weeks) or AHFX (52.5-55 Gy in 20 fractions over 4 weeks) using 6-MV beams.
- Endpoints included overall survival, LFS, loco-regional control, and toxicity, with a median follow-up of 4.9 years.
Main Results:
- Five-year loco-regional control was significantly higher in T1N0 patients treated with AHFX compared to SFX (95% vs. 75%, P=0.002).
- Loco-regional control for T2N0 patients was similar between AHFX and SFX (81% vs. 80%, P=0.813).
- Five-year LFS was improved with AHFX in T1N0 patients (95% vs. 75%, P=0.003) and comparable in T2N0 patients (92% vs. 80%, P=0.291). Toxicity was low and comparable between groups, with no grade 4 or 5 late toxicity observed.
Conclusions:
- Accelerated/hypofractionated radiotherapy (AHFX) using 6-MV beams demonstrates superior loco-regional control for T1N0 early glottic cancer compared to standard fractionation (SFX).
- AHFX provides equivalent laryngectomy-free survival and acceptable toxicity profiles when compared to SFX for early glottic cancer.
- AHFX represents a viable and potentially more efficient treatment option for select patients with early glottic carcinoma.
