Abstract
Aim: The objective of the study is to compare the locoregional control in patients of early Ca larynx treated with hypofractionated versus conventional fractionated radiotherapy.
Material and Methods: Patients with histo-pathologically proven cases of early stage Ca larynx (T1N0M0 and T2N0M0) attending Radiotherapy OPD of our institute between November 2015 and November 2016.Total of 30 patients in each arm were allocated and total of 60 patients were enrolled.
Result: In this study, the most common site of primary tumor was supraglottic (53.3%) followed by glottis (46.7%). Complete response (CR) in hypofractionated (Arm A) was (96.7%) with a partial response (PR) of (3.3%) versus Complete response (CR) of (93.3%) in conventional fractionated radiotherapy (Arm B) with a partial response (PR) of (6.7%). Locoregional control at median follow-up of 1yr was (93.3%) in hypofractionated radiotherapy (Arm A) and in conventional radiotherapy (Arm B) was of (96.7%) in patients of Early Ca larynx.
Conclusion: Most of our patients were Males with stage II disease. Major subsite was supraglottic followed by glottis. In early treatment response assessment response was comparable to similar studies.
Keywords: Conventional radiotherapy, Early Ca larynx, hypofractionated radiotherapy.
References
- Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29
- Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB. Management of T1-T2 glottic carcinomas. Cancer. 2004;100(9):1786–92
- Alam M, Perween R.Siddisui S, Accelerated versus conventional radiation fractionation in early stage carcinoma larynx. Indian J cancer 2016;53:402-7
- Wynder EL. The epidemiology of cancers of upper alimentary and upper respiratory tracts. Laryngoscope1978;88:50-1
- Delsupehe KG, Zink I, Lejaegere M, Bastian RW. Voice quality after narrow-margin laser cordectomy compared with laryngeal irradiation. Otolaryngol Head Neck Surg. 1999;121(5):528–33.
- Mendenhall WM, Amdur RJ, Morris CG, Hinerman RW. T1-T2N0 squamous cell carcinoma of the glottic larynx treated with radiation therapy. J Clin Oncol. 2001;19(20):4029–36.
- Yamazaki H, Nishiyama K, Tanaka E, Koizumi M, Chatani M. Radiotherapy for early glottic carcinoma (T1N0M0): results of prospective randomized study of radiation fraction size and overall treatment time. Int J Radiat Oncol Biol Phys. 2006;64(1):77–8
- LeQT, Fu KK, Kroll S, Ryu JK, Quivey JM, Meyler TS, et al. Influence of fraction size, total dose, and overall time on local control of T1-T2 glottic carcinoma. Int J Radiat Oncol Biol Phys. 1997;39(1):115–26.
- Trotti 3rd A, Zhang Q, Bentzen SM, Emami B, Hammond ME, Jones CU, et al. Randomized trial of hyperfractionation versus conventional fractionation in T2 squamous cell carcinoma of the vocal cord (RTOG 9512). Int J Radiat Oncol Biol Phys. 2014;89(5):958–63
- Cheah NL, Lupton S, Marshall A, Hartley A, Glaholm J. Outcome of T1N0M0 squamous cell carcinoma of the larynx treated with short-course radiotherapy to a total dose of 50 Gy in 16 fractions: the Birmingham experience. Clin Oncol (R Coll Radiol). 2009;21(6):494–501
- Gowda RV, Henk JM, Mais KL, Sykes AJ, Swindell R, Slevin NJ. Three weeks radiotherapy for T1 glottic cancer: the Christie and Royal Marsden Hospital Experience. Radiother Oncol. 2003;68(2):105–1
- Moon SH, Cho KH, Chung EJ, Lee CG, Lee KC, Chai GY, et al. A prospective randomized trial comparing hypofractionation with conventional fractionation radiotherapy for T1-2 glottic squamous cell carcinomas: results of a Korean Radiation Oncology Group (KROG-0201) study. Radiother Oncol. 2014;110(1):98–103.
- Fowler JF. Fractionation and glottic carcinoma. Int J Radiat Oncol Biol Phys. 1997;39(1):1–2
- Kim TG, Ahn YC, Nam HR, Chung MK, Jeong HS, Son YI, et al. Definitive radiation therapy for early glottic cancer: experience of two fractionation schedules. Clin Exp Otorhinolaryngol. 2012;5(2):94–100.
- Jones TM, De M, Foran B,Harrington K, Mortimore S, Laryngeal cancer: United Kingdom National Multidisciplinary guidelines J Laryngeal Otol. 2016;130 (S2):S75-S82.
Corresponding Author
Mannavi Suman
Department of Radiotherapy, Medical College Kolkata, India