Does Anterior Commissure Involvement Matter for Early-Stage Glottic Cancer in the Intensity-Modulated Radiotherapy...

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Cancer Research

Background:

• Anterior commissure involvement (ACI) is a known negative prognostic factor for local control (LC) in early-stage glottic cancer (ESGC).
• The prognostic significance of ACI in the context of modern radiotherapy techniques, specifically intensity-modulated radiotherapy (IMRT), requires further clarification.

Purpose of the Study:

• To evaluate the prognostic significance of anterior commissure involvement (ACI) in early-stage glottic cancer (ESGC).
• To assess the impact of different radiotherapy techniques (conventional vs. IMRT) on local control in ESGC patients with ACI.

Main Methods:

• Retrospective analysis of 154 ESGC patients treated with definitive radiotherapy between 2000 and 2024.
• Comparison of local recurrence-free survival (LRFS) rates between patients with and without ACI, stratified by radiotherapy technique (2D/3D-CRT vs. IMRT).

Main Results:

• The overall 5-year local recurrence-free survival (LRFS) rate was 80%.
• ACI was associated with significantly lower 5-year LRFS in patients treated with conventional 2D/3D-CRT (71% vs. 90%, p=0.03).
• No significant difference in 5-year LRFS was observed for ACI patients treated with IMRT (81% vs. 77%, p=0.13).

Conclusions:

• Anterior commissure involvement is linked to poorer local control in ESGC patients receiving radiotherapy.
• Intensity-modulated radiotherapy may potentially reduce the negative prognostic impact of ACI on local control.
• These findings suggest IMRT could be a valuable strategy for optimizing treatment in ESGC patients with ACI.