Poor local control of ulcerative T1 glottic cancer treated with 2.25-Gy per fraction radiotherapy.

Abstract

The Tokai Study Group for Therapeutic Radiology and Oncology (TOSTRO) started managing T1 glottic cancer using 2.25 Gy/fraction radiotherapy in 2011. The aim was to evaluate the local control (LC) rate and toxicity with 2.25-Gy radiotherapy in clinical practice and identify prognostic factors.The eligibility criteria were T1 glottic squamous cell carcinoma patients with age ≥20 years, treated with 2.25 Gy/fraction without chemotherapy between 2011 and 2017. LC rates were evaluated based on age, performance status, sex, T-category, tumor type (ulcerative or non-ulcerative), presence of anterior commissure invasion, tumor size, X-ray beam energy, and overall treatment time. Acute and late adverse events were evaluated using CTCAE version 4.0. A total of 202 patients were enrolled. The median follow-up period was 34.2 months. The 2- and 4-year LC rates were 93.8% and 93.1%, respectively. There was a significant difference in the LC rate between non-ulcerative type and ulcerative type (95.2% vs. 74.1% at 2 years, 94.4% vs. 74.1% at 4 years; p = 0.01). On univariate analysis, only tumor type was significantly correlated with a poor LC rate (hazard ratio 4.3; 95% confidence interval 1.2-15.4; p = 0.03). Acute grade 3 adverse events occurred in 17 patients. However, no late adverse events of grade 3 or higher have occurred to date. T1 glottic cancer treatment outcomes using hypofractionated radiotherapy with 2.25 Gy/fraction in clinical practice were comparable to previously reported results. However, ulcerative type tumor was associated with a poor LC rate.

• Authors: Yumi Oie, Yoshiyuki Itoh, Mariko Kawamura, Yuuki Takase, Takayuki Murao, Shunichi Ishihara, Yoshihito Nomoto, Naoki Hirasawa, Akiko Asano, Kouji Yamakawa, Junji Ito, Fumie Kinoshita, Shinji Naganawa
• Journal: Nagoya journal of medical science (Nagoya J Med Sci) Vol. 83 Issue 4 Pg. 811-825 (Nov 2021) ISSN: 2186-3326 [Electronic] Japan
• PMID: 34916724 (Publication Type: Journal Article)

Topics

• Adult
• Carcinoma, Squamous Cell (pathology, radiotherapy)
• Dose Fractionation, Radiation
• Glottis
• Humans
• Laryngeal Neoplasms (pathology, radiotherapy)
• Radiation Oncology
• Tongue Neoplasms
• Treatment Outcome
• Young Adult