"Radical Radiotherapy for Early-Stage Carcinoma of the Glottis. Should We Switch to Hypofractionation?"

Abstract

Introduction:We present our current experience regarding radiotherapy (RT) of early glottic cancer, and we investigate the possibility for further improvement with hypofractionation.Methods: Patients treated between May 2016 and October 2021 with definitive radiotherapy for T1-2 N0 squamous-cell carcinoma of the glottis were reviewed retrospectively. The probabilities of local control, ultimate local control (after salvage surgery), cause specific survival (CSS) and overall survival (OS) are presented. Results:We report on 57 treated patients, with median age of 68 years (49 to 88 years). The median follow-up time was 46 (12 to 74) months. 20 (35.1%), 13 (22.8%) and 24 (42.1 %) of patients had T1a, T1b and T2 disease respectively. Five-year actuarial local control rates were as follows: T1 90.9 %, T2 79.2 % (p=0.205) and overall 86%. Local control rates after salvage surgery were: T1 97 % and T2% 95.8% (p=0.887) and overall 96.5 %. Five-year disease specific survival and overall survival were 96.5% and 86% respectively. There were no significant associations with T-stage, overall treatment time, histological grade with local control on univariate analysis. Only 2 patients (3.5 %) required short-term parenteral nutrition during radiotherapy. One patient required a tracheostomy due to a non-functioning larynx one year post radiotherapy. Second primary cancers developed in 17.5 % of patients. Conclusion:Our results show that there might be room for improvement for both T1 and T2, but especially T2-staged tumors. A reasonable way to investigate, is the employment of hypofractionation (HFX) RT.