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. 2012 Jun;5(2):94-100.
doi: 10.3342/ceo.2012.5.2.94. Epub 2012 Jun 12.

Definitive radiation therapy for early glottic cancer: experience of two fractionation schedules

Tae Gyu Kim  1 , Yong Chan Ahn, Hee Rim Nam, Man Ki Chung, Han-Sin Jeong, Young-Ik Son, Chung-Hwan Baek
Affiliations

Definitive radiation therapy for early glottic cancer: experience of two fractionation schedules

Tae Gyu Kim et al. Clin Exp Otorhinolaryngol. 2012 Jun.

Abstract

Objectives: The authors would report the results of definitive radiation therapy (RT) for early glottic cancer by two different radiation dose schedules.

Methods: From February of 1995 till June of 2008, 157 patients with T1-2N0 glottic cancer were treated with curative RT at Samsung Medical Center. All patients had squamous cell carcinoma, and there were 89 patients (56.7%) with T1a, 36 (22.9%) with T1b, and 32 (20.4%) with T2. Two different radiation dose schedules were used: 70 Gy in 35 fractions to 64 patients (40.8%, group A); and 67.5 Gy in 30 fractions to 93 patients (59.2%, group B). The median treatment durations were 50 days (range, 44 to 59 days) and 44 days (range, 40 to 67 days) in the groups A and B, respectively.

Results: The median follow-up durations were 85 and 45 months for the groups A and B. No severe late complication of RTOG grade 3 or higher was observed, and there was no difference in acute or chronic complication between the groups. Twenty-four patients experienced treatment failure: local recurrence only in 19 patients; regional recurrence only in one; combined local and regional recurrence in four; and systemic metastasis in none. The overall 5-year disease-free survival and disease-specific survival rates were 84.7% and 94.8%. The disease-free survival rate in the group B was better (78.3% vs. 90.8%, P=0.031). This difference was significant only in T1 stage (83.4% vs. 94.6%, P=0.025), but not in T2 (62.7% vs. 60.6%, P=0.965). Univariate analysis showed that the tumor extent, cord mobility, T-stage, and the dose schedule had significant influence on the disease-free survival, and multivariate analysis showed that only the tumor extent and the dose schedule were associated with the disease-free survival.

Conclusion: Superior disease-free survival could be achieved by 2.25 Gy per fraction without increased toxicity over shorter RT duration, when compared with 2.0 Gy per fraction.

Keywords: Dose fractionation; Laryngeal neoplasms; Radiotherapy.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Disease-free survival (A), overall survival (B), and disease-specific survival (C) of the patients with early glottic cancer treated by definitive radiation therapy.
Fig. 2
Fig. 2
Impact of fraction size by T-stage: disease-free survival rates at 5 years were 83.4% and 94.6% in the groups A and B of T1 patients (P=0.025) (A), and 62.7% and 60.6% in the groups A and B of T2 patients (P=0.965), respectively (B).
See this image and copyright information in PMC

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