Optimized radiotherapy treatment strategy for early glottic carcinoma

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Cancer

Background:

• Radiation therapy alone shows unsatisfactory local control rates for T1 bulky and T2 glottic carcinoma.
• Early glottic carcinoma requires optimized treatment strategies to improve patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of a specific treatment protocol for early glottic carcinoma.
• To compare local control rates between radiation therapy alone and concurrent chemoradiotherapy for T1 bulky and T2 glottic carcinoma.

Main Methods:

• Retrospective review of 80 early glottic squamous cell carcinoma patients treated between January 2007 and November 2019.
• Treatment arms included radiation therapy alone (T1 non-bulky), concurrent chemoradiotherapy with S-1 (T1 bulky, T2 favorable), and concurrent chemoradiotherapy with high-dose cisplatin (T2 unfavorable).
• Local failure rates, survival rates, and adverse events were analyzed using cumulative incidence function and Kaplan-Meier analysis.

Main Results:

• The 3-year local failure rate was 5.8%, with disease-specific survival at 98.3% and overall survival at 94.4%.
• Concurrent chemoradiotherapy demonstrated significantly lower local failure rates in T1 bulky and T2 cases compared to radiation therapy alone.
• Grade 3 acute dermatitis and mucositis were observed in 9 and 4 patients, respectively, with no Grade 4+ acute or Grade 2+ late adverse events.

Conclusions:

• The evaluated treatment protocol, particularly concurrent chemoradiotherapy, is effective and well-tolerated for early glottic carcinoma.
• Concurrent chemoradiotherapy shows promise in reducing local failure rates for T1 bulky and T2 glottic carcinoma.
• This approach offers an improved therapeutic option for managing early-stage glottic squamous cell carcinoma.