Intensity-modulated radiotherapy for stage I glottic cancer: a short-term outcomes compared with three-dimensional conformal radiotherapy

Cho, Ick Joon; Chung, Woong‐Ki; Lee, Joon Kyoo; Lee, Min-Cheol; Paek, Jayeong; Kim, Yong-Hyub; Jeong, Jae‐Uk; Yoon, Myung Ha; Song, Jong Tae; Nam, Taek‐Keun; Ahn, Sung‐Ja; Lee, Dong Hoon; Yoon, Tae Mi; Lim, Sang-Chul

doi:10.3857/roj.2019.00283

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…In contrast to this analysis, existing retrospective data suggests similar disease control outcomes between 3D-CRT and IMRT, with potentially less toxicity with IMRT; however, these are all single-institution studies. [14][15][16] This study supports a recent publication using the National Cancer Database (NCDB) to compare 3D-CRT to IMRT for early stage glottic cancer, which found no difference in OS. 17 However, due to the limitations of the NCDB, the authors were unable to comment on CSS.…”

Section: Discussionsupporting

confidence: 82%

Outcomes between intensity‐modulated radiation therapy versus 3D‐conformal in early stage glottic cancer

et al. 2021

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Background The purpose of this study is to evaluate practice patterns and outcomes between intensity‐modulated radiation therapy (IMRT) and 3D‐conformal radiation (3D‐CRT) in early stage glottic cancer. Methods The linked Surveillance, Epidemiology, and End Results (SEER)‐Medicare database was used to identify and compare patient and disease profiles, mortality, and toxicity in patients with T1‐2 larynx cancer undergoing definitive radiation (RT). Results A total of 1520 patients underwent definitive radiation with 3D‐CRT (n = 1309) or IMRT (n = 211). Non‐white race, those with a Charlson Comorbidity Index ≥2, T2 disease, and those treated at community practices were more likely to undergo IMRT. Rates of IMRT increased from 2006 to 2015, while relative rates of 3D‐CRT decreased. Two‐year CSS was superior with 3D‐CRT (hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.22–0.65; p < 0.001). There was no difference in OS between 3D‐CRT and IMRT (p = 0.119). Conclusions Patients receiving 3D‐CRT had improved CSS compared to IMRT with no difference in OS.

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Section: Discussionsupporting

confidence: 82%

Outcomes between intensity‐modulated radiation therapy versus 3D‐conformal in early stage glottic cancer

et al. 2021

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“…In view of these previous reports, efforts shall be made to keep the dose to the carotid artery to a minimum as much as possible. Many investigators have reported that IMRT techniques significantly reduce unnecessary radiation to the carotid arteries [ 6 – 21 ]. Although PT is another promising technology, few previously published studies have explored PT for early-stage glottic cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Consideration of advanced RT technologies with minimal impact to surrounding normal tissues is worthwhile in such cases. There are many reports on IMRT for early-stage glottic cancer [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21], but no reports have yet detailed the dose distribution characteristics of PT for early-stage glottic cancer. In this study, we therefore aimed to clarify the dose distribution between IMRT and PT for early-stage glottic cancer and examined the usefulness of PT for early-stage glottic cancer.…”

Section: Introductionmentioning

confidence: 99%

Dose-Volume Comparison of IMRT and PSPT Treatment Plans for Early-Stage Glottic Cancer

Katō

Fuwa

Murakami

2020

International Journal of Particle Therapy

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Purpose To clarify the dose distribution characteristics for early-stage glottic cancer by comparing the dose distribution between intensity-modulated radiation therapy (IMRT) and passive scattering proton therapy (PSPT) and to examine the usefulness of PSPT for early-stage glottic cancer. Materials and Methods Computed tomography datasets of 8 patients with T1-2 glottic cancer who had been treated by PSPT were used to create an IMRT plan in Eclipse with 7 fields and a PSPT plan in XiO-M with 2 fields. Organs at risk (OARs) included the carotid arteries, arytenoids, inferior constrictor muscles, strap muscles, thyroid cartilage, cricoid cartilage, and spinal cord. The prescription dose was 66 GyRBE in 33 fractions to the planning target volume (PTV). All plans were optimized such that 95% of the PTV received 90% of the prescription dose considering that the skin was slightly spared. Results The superiority of the PSPT was confirmed in all OARs. In the PSPT, the dose to the contralateral carotid artery and the spinal cord, which is slightly distant from the PTV, was dramatically reduced while maintaining the dose distribution uniformity of the PTV by comparison with IMRT. Conclusion PSPT for early-stage glottic cancer resulted in good target dose homogeneity and significantly spared the OARs as compared with the IMRT. PSPT is expected to be effective in reducing late effects and particularly useful for young people.

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“…There was a trend for increased local recurrences in the T2 N0 population, which highlighted the potential consequences for not adequately appreciating the risk of local subclinical spread above or below the glottis. Although follow-up periods are short, the dosimetric advantages to OARs and comparable local control rates for IMRT and VMAT have been further demonstrated by numerous retrospective analyses (11,(103)(104)(105)(106)(107).…”

Section: Radiotherapy Technique and Outcomesmentioning

confidence: 99%

Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

et al. 2021

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Early-stage squamous cell cancer (SCC) of the glottis has a good prognosis. Therefore, patients have long survival outcomes and may potentially suffer from late toxicities of radiotherapy. Radiotherapy with a conventional parallel-opposed-pair or anterior-oblique beam arrangements for stage 1 and 2 glottic SCC have field borders that traditionally cover the entire larynx, exposing organs-at-risk (e.g. carotid arteries, contralateral vocal cord, contralateral arytenoid and inferior pharyngeal constrictor muscles) to high radiation doses. The potential long-term risk of cerebrovascular events has attracted much attention to the dose that carotid arteries receive. Swallow and respiratory motion of laryngeal structures has been an important factor that previously limited reduction of the radiation treatment volume. Motion has been evaluated using multiple imaging modalities and this information has been used to calculate PTV margins for generation of more limited target volumes. This review discusses the current literature surrounding dose-effect relationships for various organs-at-risk and the late toxicities that are associated with them. This article also reviews the currently available data and effects of laryngeal motions on dosimetry to the primary target. We also review the current limitations and benefits of a more targeted approach of radiotherapy for early-stage glottic SCCs and the evolution of CT-based IGRT and MR-guided radiotherapy techniques that may facilitate a shift away from a conventional 3D-conformal radiotherapy approach.

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Intensity-modulated radiotherapy for stage I glottic cancer: a short-term outcomes compared with three-dimensional conformal radiotherapy

Cited by 6 publications

References 28 publications

Outcomes between intensity‐modulated radiation therapy versus 3D‐conformal in early stage glottic cancer

Outcomes between intensity‐modulated radiation therapy versus 3D‐conformal in early stage glottic cancer

Dose-Volume Comparison of IMRT and PSPT Treatment Plans for Early-Stage Glottic Cancer

Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

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