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. 2023 Sep-Oct;37(5):2320-2326.
doi: 10.21873/invivo.13335.

Clinical Outcomes of Radiotherapy for Stage 1 Glottic Carcinoma: Comparing Accelerated Hyperfractionation and Once-daily Fractionation

Masashi Endo  1 , Yukiko Fukuda  2 , Kohei Okada  2 , Kazunari Ogawa  2 , Michiko Nakamura  2 , Satoru Takahashi  2 , Eri Murakami  2   3 , Chiaki Shibayama  2   4 , Masahiro Kawahara  5 , Keiko Akahane  5 , Ryutaro Onaga  6   7 , Takafumi Nagatomo  6 , Takeharu Kanazawa  6 , Hiroshi Nishino  6 , Harushi Mori  2 , Katsuyuki Shirai  2   5
Affiliations

Clinical Outcomes of Radiotherapy for Stage 1 Glottic Carcinoma: Comparing Accelerated Hyperfractionation and Once-daily Fractionation

Masashi Endo et al. In Vivo. 2023 Sep-Oct.

Abstract

Background/aim: Accelerated hyperfractionation (AHF) is used in head and neck cancer to improve the local control (LC) rate, but reports of outcomes for early-stage GC are limited. The outcomes of radiotherapy (RT) for stage 1 glottic carcinoma (GC) were retrospectively analyzed, comparing AHF and once-daily fractionation (ODF) using 2.0-2.4 Gy.

Patients and methods: A total of 102 patients with stage 1 GC underwent RT alone between 2007 and 2021, with 43 in the AHF group and 59 in the ODF group. A p-value less than 0.05 was considered to indicate a significant difference.

Results: The 5-year LC rate was 98% in the AHF group and 91% in the ODF group (p=0.19). During RT, significantly more patients in the AHF group required opioids due to mucositis than in the ODF group (74% vs. 25%, p<0.001), and the rate of aspiration pneumonia tended to be higher in the AHF group than in the ODF group (7% vs. 0%, p=0.072).

Conclusion: There was no difference in the LC rate between AHF and ODF for stage 1 GC. Moreover, the AHF group required opioids at a higher rate and tended to have a higher risk of developing aspiration pneumonia.

Keywords: Glottic cancer; accelerated hyperfractionation; aspiration pneumonia; opioid; radiotherapy.

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Conflict of interest statement

The Authors declared no potential conflicts of interest concerning this research, authorship, and/or publication.

Figures

Figure 1
Figure 1. Kaplan-Meier plots of overall survival rates. The solid line indicates accelerated hyperfractionation (AHF), and the dashed line indicates once-daily fractionation (ODF).
Figure 2
Figure 2. Kaplan-Meier plots of local control rates. The solid line indicates accelerated hyperfractionation (AHF), and the dashed line indicates once-daily fractionation (ODF).
Figure 3
Figure 3. Kaplan-Meier plots of laryngeal preservation rates. Laryngeal preservation is defined as the condition in which a total laryngectomy is not performed and includes a condition in which a partial laryngectomy is performed. The solid line indicates accelerated hyperfractionation (AHF), and the dashed line indicates once-daily fractionation (ODF).
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