Prospective Observational Comparative Study of Response and Toxicities in Early Glottic Cancer Using Telecobalt...

Area of Science:

• Oncology
• Radiation Therapy
• Head and Neck Cancers

Background:

• Head and neck cancers are a significant global health concern.
• Conventional telecobalt radiotherapy (2DRT) and 3D-conformal radiotherapy (3D-CRT) are treatment modalities.
• Assessing the comparative efficacy and toxicity of these techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the treatment response and toxicity profiles of 2DRT and 3D-CRT in patients with early-stage head and neck cancers (T1N0M0 and T2N0M0).
• To evaluate the feasibility of 2DRT as an alternative to 3D-CRT in resource-constrained environments.

Main Methods:

• A study involving 50 patients divided into two arms: Arm A (2DRT) and Arm B (3D-CRT).
• Both arms received 66 Gy/33 fractions of radiation.
• Acute and late toxicities (skin reaction, dysphagia, laryngeal toxicity) were assessed using RTOG/EORTC criteria.
• Treatment response was evaluated via fiber optic laryngoscopy at 6 weeks and 3 months post-treatment.

Main Results:

• Complete response rates at 6 weeks were 83.3% for 2DRT and 88.5% for 3D-CRT; at 3 months, rates were 85.0% and 95.7%, respectively.
• No significant superiority of 3D-CRT over 2DRT was observed in treatment response.
• Grade 3 toxicities were comparable between the two arms, with some instances of dysphagia, dermatitis, and laryngeal toxicity noted.
• 3D-CRT is more time-consuming, less available, and costlier than 2DRT in India.

Conclusions:

• Conventional telecobalt radiotherapy (2DRT) demonstrates comparable efficacy and toxicity to 3D-CRT for early-stage head and neck cancers.
• Given its lower cost and greater availability, 2DRT can be considered a practical option for patients in India.
• Further randomized studies with larger sample sizes and long-term follow-up are recommended to validate these findings.