Radiotherapy for early glottic carcinoma (T1N0M0): Results of prospective randomized study of radiation fraction size and overall treatment time

Yamazaki, Hideya; Nishiyama, Kinji; Tanaka, Eiichi; Koike, Masahiko; Chatani, Masashi

doi:10.1016/j.ijrobp.2005.06.014

Cited by 238 publications

(231 citation statements)

References 13 publications

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“…30 Hypofractionated protocols are expected to cause more frequent late complications, while accelerated protocol should cause more acute toxicity, contrary to our results shown in Table 4. 13,31,32 In our study 2 out of 3 manifestations of early toxicity graded 2 or more according to the Dische scale were more frequent in the H group while 3 out of 9 late toxicity manifestations occurred more frequently in the A group. There were no significant differences in overall frequency of early and late toxicity of any grade among the A, H and S groups.…”

Section: Discussionsupporting

confidence: 48%

“…12,18,[22][23][24][25] In some reports these indicators reach 100%. 2,13,26 The publications on hypofractionated accelerated RT for larynx cancer present results in T1-T2 tumors while in our study T3 tumors were diagnosed in 8% of patients in the H group. In the subgroup of patients with T1-T2 tumors (92% of H group) 5-year OS and PFS were 90%…”

Section: Discussionmentioning

confidence: 41%

“…There was a statistically significant difference in 5-year local control in favor of the hypofractionated group (92% vs. 67%). 13 Also, Yu et al reported better results in a hypofractionated group (2.25-2.5 Gy) as compared to a standard 2.0 Gy fractionation. 25 Rudoltz et al found that fraction dose ≥2.0 Gy was more effective for local control than doses <2.0 Gy.…”

Section: Discussionmentioning

confidence: 97%

“…33 Two papers report results of randomized trials. 13,23 Due to differences in methodology, endpoints and follow-up duration the comparison of results is of a limited value. No difference in toxicity between standard and hypofractionated protocols was found in published reports of hypofractionated RT of the laryngeal cancer.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Szutkowski

Kawecki

Jarząbski

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 41%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Szutkowski

Kawecki

Jarząbski

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Voice Outcome in T1a Midcord Glottic Carcinoma

Sjögren

Rossum²,

Langeveld³

et al. 2008

Arch Otolaryngol Head Neck Surg

100

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To compare voice quality after radiotherapy or endoscopic laser surgery in patients with similar T1a midcord glottic carcinomas according to a validated multidimensional protocol. Design: Retrospective cohort study. Setting: University cancer referral center. Patients: Two cohorts of consecutive patients willing to participate after treatment for primary T1a midcord glottic carcinoma with laser surgery (18 of 23 eligible) or radiotherapy (16 of 18 eligible). Main Outcome Measures: Posttreatment voice quality was evaluated according to a multidimensional voice protocol based on validated European Laryngological Society recommendations, including perceptual, acoustic, aerodynamic, and stroboscopic analyses, together with patient self-assessment using the Voice Handicap Index. Results: Approximately half of the patients had mild to moderate voice dysfunction in the perceptual analysis (53% [8 of 15] in the radiotherapy group and 61% [11 of 18] in the laser surgery group) and on the Voice Handicap Index (44% [7 of 16] in the radiotherapy group and 56% [10 of 18] in the laser surgery group). The voice profile in the laser surgery group was mainly breathy; in the radiotherapy group, it was equally breathy and rough, with a trend for more jitter in the acoustic analysis. There was no statistical difference in the severity of voice dysfunction between the groups in any of the variables. Conclusions: Endoscopic laser surgery offers overall voice quality equivalent to that of radiotherapy for patients with T1a midcord glottic carcinoma, although specific voice profiles may ultimately be different for the 2 modalities. We believe that endoscopic laser surgery is the preferred treatment in these patients because it provides oncologic control similar to that of radiotherapy and the additional benefits of lower costs, shorter treatment time, and the possibility of successive procedures.

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Accelerated Hypofractionated Chemoradiation Followed by Stereotactic Ablative Radiotherapy Boost for Locally Advanced, Unresectable Non–Small Cell Lung Cancer

Wu,

Luterstein,

Neilsen

et al. 2024

JAMA Oncol

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ImportanceIntrathoracic progression remains the predominant pattern of failure in patients treated with concurrent chemoradiation followed by a consolidation immune checkpoint inhibitor for locally advanced, unresectable non–small cell lung cancer (NSCLC).ObjectiveTo determine the maximum tolerated dose (MTD) and use of hypofractionated concurrent chemoradiation with an adaptive stereotactic ablative radiotherapy (SABR) boost.Design, Setting, and ParticipantsThis was an early-phase, single-institution, radiation dose-escalation nonrandomized controlled trial with concurrent chemotherapy among patients with clinical stage II (inoperable/patient refusal of surgery) or III NSCLC (American Joint Committee on Cancer Staging Manual, seventh edition). Patients were enrolled and treated from May 2011 to May 2018, with a median patient follow-up of 18.2 months. Patients advanced to a higher SABR boost dose if dose-limiting toxic effects (any grade 3 or higher pulmonary, gastrointestinal, or cardiac toxic effects, or any nonhematologic grade 4 or higher toxic effects) occurred in fewer than 33% of the boost cohort within 90 days of follow-up. The current analyses were conducted from January to September 2023.InterventionAll patients first received 4 Gy × 10 fractions followed by an adaptive SABR boost to residual metabolically active disease, consisting of an additional 25 Gy (low, 5 Gy × 5 fractions), 30 Gy (intermediate, 6 Gy × 5 fractions), or 35 Gy (high, 7 Gy × 5 fractions) with concurrent weekly carboplatin/paclitaxel.Main Outcome and MeasureThe primary outcome was to determine the MTD.ResultsData from 28 patients (median [range] age, 70 [51-88] years; 16 [57%] male; 24 [86%] with stage III disease) enrolled across the low- (n = 10), intermediate- (n = 9), and high- (n = 9) dose cohorts were evaluated. The protocol-specified MTD was not exceeded. The incidences of nonhematologic acute and late (&gt;90 days) grade 3 or higher toxic effects were 11% and 7%, respectively. No grade 3 toxic effects were observed in the intermediate-dose boost cohort. Two deaths occurred in the high-dose cohort. Two-year local control was 74.1%, 85.7%, and 100.0% for the low-, intermediate-, and high-dose cohorts, respectively. Two-year overall survival was 30.0%, 76.2%, and 55.6% for the low-, intermediate-, and high-dose cohorts, respectively.Conclusions and RelevanceThis early-phase, dose-escalation nonrandomized controlled trial showed that concurrent chemoradiation with an adaptive SABR boost to 70 Gy in 15 fractions with concurrent chemotherapy is a safe and effective regimen for patients with locally advanced, unresectable NSCLC.Trial RegistrationClinicalTrials.gov Identifier: NCT01345851

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Radiotherapy for early glottic carcinoma (T1N0M0): Results of prospective randomized study of radiation fraction size and overall treatment time

Cited by 238 publications

References 13 publications

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

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

Voice Outcome in T1a Midcord Glottic Carcinoma

Accelerated Hypofractionated Chemoradiation Followed by Stereotactic Ablative Radiotherapy Boost for Locally Advanced, Unresectable Non–Small Cell Lung Cancer

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