Moderate hypofractionation for early laryngeal cancer improves local control: a systematic review and meta-analysis

Benson, Rony; Prashanth, G. K.; Mallick, Supriya

doi:10.1007/s00405-020-06012-9

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…One of the concerns about applying hypofractionated RT is the potential of increased toxicity. Some studies with moderate hypofractionation with fraction size of 2.2-2.5 Gy reported higher incidences of acute toxicity [20,21]. The crude rates of occurrence of acute hoarseness, mucositis, and radiation dermatitis in the current study were high; however, all reported acute toxicities were mild except one case of grade 3 mucositis.…”

Section: Discussioncontrasting

confidence: 53%

Hypofractionated radiotherapy for early stage glottic cancer: efficacy of 3.5 Gy per fraction

Lee

Kwon

et al. 2022

Radiat Oncol J

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Purpose: The purpose of this study was to evaluate the treatment outcomes and toxicity profile of patients with early glottic cancer who underwent hypofractionated radiation therapy (RT) with 3.5 Gy per fraction.Materials and Methods: A retrospective review was performed of the medical records of 35 patients with early stage (T1-2N0M0) glottic cancer who underwent definitive RT. The dose fractionation scheme was 59.5 Gy in 17 fractions. Posterior commissure was excluded from the clinical target volume (CTV) for 26 patients (74.3%) without glottic lesions close to this region. Results: With a median follow-up of 16.23 months (range, 6.82 to 67.15 months), no local, regional, or distant recurrence was reported. Acute hoarseness (65.7%), mucositis (68.6%), radiation dermatitis (60.0%) was frequent. One patient (2.9%) reported grade 3 acute toxicity (mucositis) and there was no grade 4–5 acute toxicity. There was no grade ≥3 late toxicities; however, grade 1 late intermittent hoarseness was frequent (45.7%). The receiver operative characteristic analysis revealed that mean hypopharyngeal dose was predictive for acute grade ≥2 mucositis (area under the curve=0.9314; 95% confidence interval, 0.8524–1). The optimal threshold of mean hypopharyngeal dose for occurrence of acute grade ≥2 mucositis was 26.31 Gy, with a specificity and sensitivity of 83.3% and 88.2%, respectively.Conclusion: Hypofractionated RT with fraction size of 3.5 Gy for early glottic cancer is effective. The hypopharyngeal mean dose could predict the occurrence of grade ≥2 acute mucositis. The posterior commissure can be safely excluded from the CTV.

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Section: Discussioncontrasting

confidence: 53%

Hypofractionated radiotherapy for early stage glottic cancer: efficacy of 3.5 Gy per fraction

Lee

Kwon

et al. 2022

Radiat Oncol J

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“…The treatment of early-stage glottic cancer, was examined in 44 studies, [29][30][31][35][36][37][38]40,41,45,46,48,50-59,62,64,65,71,72,74-77,79-82,89-94 mainly with transoral laser microsurgery and RT modalities (Figure 2). techniques with different laser modalities and robotic-assisted transoral surgery were observed, however, not only surgical techniques improved, as RT is using intensity-modulated radiation to precisely select normal tissues and targets for treatment, providing curative treatment with less toxicities.…”

Section: Resultsmentioning

confidence: 99%

“…The PubMed database search yielded a total of 260 studies (Table A1), of which 68 (26 MAs, 24 RCTs, and 18 SRs) fulfilled the selection criteria 9,13–15,29–31,33,35–94 . The countries in which the largest numbers of studies were performed were China ( n = 18), the United Kingdom ( n = 6), and Italy ( n = 5; Figure 1).…”

Section: Resultsmentioning

confidence: 99%

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Overview of glottic laryngeal cancer treatment recommendation changes in the NCCN guidelines from 2011 to 2022

Arboleda,

Neves,

Kohler

et al. 2023

Cancer Reports

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BackgroundThe treatment of glottic cancer remains challenging, especially with regard to morbidity reduction and larynx preservation rates. The National Comprehensive Cancer Network (NCCN) has published guidelines to aid decision‐making about this treatment according to the tumor site, clinical stage, and patient medical status.AimThe present review was conducted to identify changes in the NCCN guidelines for glottic cancer treatment made between 2011 and 2022 and to describe the published evidence concerning glottic cancer treatment and oncological outcomes in the same time period.Methods and ResultsClinical practice guidelines for head and neck cancer published from 2011 up to 2022 were obtained from the NCCN website (www.NCCN.org). Data on glottic cancer treatment recommendations were extracted, and descriptive analysis was performed. In addition, a review of literature registered in the PubMed database was performed to obtain data on glottic cancer management protocols and treatment outcomes from randomized controlled trials, systematic reviews, and meta‐analyses published from 2011 to 2022. In total, 24 NCCN guidelines and updates and 68 relevant studies included in the PubMed database were identified. The main guideline changes made pertained to surgical and systemic therapies, the consideration of adverse features, and new options for the treatment of metastatic disease at initial presentation. Early‐stage glottic cancer received the most research attention, with transoral endoscopic laser surgery and radiotherapy assessed and compared as the main treatment modalities. Reported associations between treatment types and survival rates for this stage of glottic cancer appear to be similar, but functional outcomes can be highly compromised.ConclusionNCCN panel members provide updated recommendations based on currently accepted treatment approaches for glottic cancer, constantly reviewing new surgical and non‐surgical techniques. The guidelines support decision‐making about glottic cancer treatment that should be individualized and prioritize patients' quality of life, functionality, and preferences.

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“…We would like to state that a comprehensive systematic search of Embase was done and no additional studies were found. We acknowledge that writing 'Embase = 0 articles' was missed in the PRISMA chart [1]. The third query raised was regarding the analysis of dichotomous variables.…”

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confidence: 99%

Moderate hypofractionation for early laryngeal cancer improves local control with increased risk of mucositis: clarification

Benson

Giridhar

Mallick

2020

Eur Arch Otorhinolaryngol

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Moderate hypofractionation for early laryngeal cancer improves local control: a systematic review and meta-analysis

Cited by 5 publications

References 7 publications

Hypofractionated radiotherapy for early stage glottic cancer: efficacy of 3.5 Gy per fraction

Hypofractionated radiotherapy for early stage glottic cancer: efficacy of 3.5 Gy per fraction

Overview of glottic laryngeal cancer treatment recommendation changes in the NCCN guidelines from 2011 to 2022

Moderate hypofractionation for early laryngeal cancer improves local control with increased risk of mucositis: clarification

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