Evaluation of acute/late toxicity and local recurrence in Τ1-Τ2 glottic carcinoma treated with accelerated hypofractionated 3D-conformal external beam radiotherapy (3D-CRT)

Abstract

BackgroundThe aim of the study was to evaluate the efficacy, as well as the acute and late toxicity of an accelerated hypofractionated 3DCRT schedule as radical treatment in patients with organ confined glottic cancer cT1-2N0.Patients and methods.Between June of 2004 and September 2010, 47 retrospectively selected patients (29 males, 18 females) diagnosed with organ confined T1 or T2 glottic cancer, were treated with external 3DCRT in an accelerated hypofractionation schedule. The median age was 70 years. A dose of 64.4 Gy in 28 daily fractions was prescribed. The primary study endpoints were to assess the acute and late effects of radiation toxicity, according to the EORTC/ RTOG scale, as well as the therapeutic impact of this schedule in terms of local recurrence.ResultsThe median follow up was 36 months. At the end of radiotherapy, grade I, II and III acute toxicity was observed in 34, 9 and4 patients, respectively. Late grade I and II toxicity was observed in 25 and in 8 patients respectively. Only two local recurrences were observed, 15 and 24 months post 3DCRT respectively.ConclusionsOur radiotherapy schedule achieves a high locoregional control rate with the advantage of voice preservation. The proposed hypofractionated schedule can be recommended as a standard radiotherapy treatment, since these results are comparable with those of conventional fractionation schedules.

Ginsenoside PPD’s Antitumor Effect via Down-Regulation of mTOR Revealed by Super-Resolution Imaging

“…However, one of the continuing challenges in the therapeutic approach towards laryngeal squamous cell carcinoma (LSCC) is the development of resistance to chemotherapy and radiation treatment [ 3 , 4 , 5 ]. Although X-ray dose escalation techniques have been used to counteract radioresistance, dose escalations to 64.4 Gy in T1–T2 glottic carcinoma yield significant acute and late toxicities [ 6 ]. As a result, a significant number of researches have aimed at the identification of novel agents capable of overcoming these adaptations.…”

Hypofractionated accelerated radiotherapy in T1–3 N0 cancer of the larynx: A prospective cohort study with historical controls

“…No difference in toxicity between standard and hypofractionated protocols was found in published reports of hypofractionated RT of the laryngeal cancer. 11,13,18,22,23,25 In majority of these reports a fraction dose of 2.25-2.5 Gy was used. The dose >3.0 Gy was linked to a higher complications rate, 13,34 but in a group of 200 patients reported by Gowda et al in which 3.12-3.28 Gy doses were used for 3 weeks up to a total of 50-52.5 Gy, early and late toxicity were low.…”

“…Similar conclusions have been proposed by other authors. 11,35 In published reports number of patients treated with hypofractionated RT was limited and authors suggested a need for further research. 10,12,18,35 The group with hypofractionated RT reported in this paper is one of the largest published so far.…”

“…8 Results similar to standard RT fractionation or better have been obtained with hypofractionated protocols. 3,[9][10][11][12][13] Both methods of altered fractionation have been shown to offer some advantages. Standard, accelerated, hyper-and hypofractionated regimes are used in clinical practice.…”