Four-Week Hypofractionated Radiotherapy for Early Glottic Cancer: A Prospective Study of Toxicity and Tolerance With...

Area of Science:

• Radiation Oncology
• Head and Neck Cancer
• Glottic Carcinoma Treatment

Background:

• Hypofractionated radiotherapy is increasingly used for early glottic cancer to improve tumor control and reduce treatment time.
• Limited data exists for hypofractionated regimens exceeding 2.5 Gy per fraction, especially for T2 glottic tumors.

Purpose of the Study:

• To evaluate the safety and efficacy of a hypofractionated radiotherapy regimen (55 Gy in 20 fractions) using VMAT for early glottic carcinoma.
• To assess toxicity and local control rates in patients with T1-T2N0M0 glottic cancer.

Main Methods:

• Prospective interventional study involving 23 patients with T1-T2N0M0 glottic carcinoma.
• Treatment delivered via volumetric modulated arc therapy (VMAT) at 55 Gy in 20 fractions (2.75 Gy/fraction) with daily image guidance.
• Primary endpoint: toxicity; Secondary endpoint: local control.

Main Results:

• A complete response was achieved in 95.7% of patients; one patient required salvage surgery.
• One-year local control rates were 91.7% for T1 and 85.7% for T2 disease, with overall 91.3%.
• Predominantly Grade 1-2 acute toxicities observed; Grade 3 events included hoarseness and dysphagia. Late toxicities were generally mild.

Conclusions:

• Hypofractionated VMAT (55 Gy/20 fractions) is a feasible and safe treatment for early glottic carcinoma.
• The regimen provides excellent tumor control for T1 disease and acceptable outcomes for T2 disease with low toxicity.
• Further research with longer follow-up and larger cohorts is needed to confirm long-term local control, particularly for T2 tumors.