Patterns of Care and Outcomes of Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy for Early Stage Glottic Cancer: A National Cancer Database Analysis

Abstract

Early stage glottic cancer has traditionally been treated with 3D conformal radiotherapy (3DCRT). However, intensity-modulated radiotherapy (IMRT) has been recently adopted as an alternative to decrease toxicity. Here, we compared the usage and outcomes of IMRT and 3DCRT for patients with early stage squamous cell carcinoma (SCC) of the glottic larynx. Using the National Cancer Database, we identified patients with Stage I–II SCC of the glottis who received 55–75 Gy using IMRT (n = 1623) or 3DCRT (n = 2696). Median follow up was 42 months with a 5-year overall survival (OS) of 72%. Using a nominal logistic regression, race, ethnicity, year of diagnosis and fraction size were associated with the receipt of IMRT (p < 0.05). Using Kaplan–Meier methods and Cox proportional hazards models as well as a propensity matched cohort, there was no difference in OS for patients who received IMRT versus 3DCRT (hazard ratio (HR), 1.08; 95% confidence interval (95% CI), 0.93–1.26; p = 0.302). However, there was a survival benefit for patients receiving slight hypofractionation as compared to conventional fractionation (HR, 0.78; 95% CI, 0.69–0.92; p = 0.003). IMRT was associated with similar survival as 3DCRT, supporting the implementation of this potentially less toxic modality without compromising survival.

WITHDRAWN: Radiation-Induced Acute Injury of Intensity-Modulated Radiotherapy vs. Three-Dimensional Conformal Radiotherapy in Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma: A Prospective Cohort Study

“…37 A National Cancer Database Analysis reports that there was no difference in OS for patients who received IMRT versus 3D-CRT, IMRT was associated with similar survival as 3D-CRT. 38 Another meta-analysis showed that the 3-year OS, DFS rates had no signi cant difference between the IMRT and 3D-CRT groups for gastric cancer, but IMRT might be superior to 3D-CRT in treating patients with gastric cancer in terms of local control rates. 21 But beyond that, there are also studies of IMRT patients had better tumor control than 3D-CRT with equal or better oncological results for anal carcinoma patients.…”

Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study

“…No survival benefits had been observed while comparing IMRT versus 3D-CRT in cervical esophageal squamous cell carcinoma patients treated by concurrent chemoradiotherapy 38 . A National Cancer Database Analysis reports that there was no difference in OS for patients who received IMRT versus 3D-CRT, IMRT was associated with similar survival as 3D-CRT 39 . Another meta-analysis showed that the 3-year OS, DFS rates had no significant difference between the IMRT and 3D-CRT groups for gastric cancer, but IMRT might be superior to 3D-CRT in treating patients with gastric cancer in terms of local control rates 22 .…”

Temporal Bone Osteoradionecrosis: An 18‐year, Single‐Institution Experience

“…Patients with no specified technique who completed irradiation before 2005 were included in the 3-dimensional conformal radiotherapy (3D-CRT) group because intensity-modulated radiation therapy (IMRT) was less common for H&N tumors until 2005. 11 Patients with reirradiation were included in the IMRT group only if all radiotherapy was delivered using IMRT. Finally, systemic therapy was defined as any chemotherapy, immunotherapy, or hormonal therapy.…”