Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

Hypofractionated Radiotherapy for Stage I Squamous Cell Carcinoma Glottis: An Experience with 60Gy in 20 Fractions

Document Type : Original Paper

Authors
Pushpaja Kuttassery Ullattil 1
Anoop Remesan Nair 2
Lakshmi Jayachandran Susheela 1
Soumya N Mazhoor 1
Sunil P.S. 1
Krishnakumar Thankappan 3
Greeshma C Ravindran 4
Debnarayan Dutta 1
1 Department of Radiation Oncology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research, Amrita Vishwa Vidyapeetham, AIMS, Ponekkara P.O., Kochi, Kerala, Pin Code 682041
2 Department of Radiation Oncology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research, Amrita Vishwa Vidyapeetham, AIMS, Ponekkara P.O., Kochi, Kerala, Pin Code 682041.
3 Department of Head and Neck Surgery and Oncology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research, Amrita Vishwa Vidyapeetham, AIMS, Ponekkara P.O., Kochi, Kerala, Pin Code 682041
4 Department of Biostatistics, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research, Amrita Vishwa Vidyapeetham, AIMS, Ponekkara P.O., Kochi, Kerala, Pin Code 682041
10.22038/ijmp.2022.62774.2073
Abstract
Introduction: Early-stage glottic cancer has a high cure rate with definitive radiotherapy. Historical reports show excellent local control. The present study evaluated the outcomes of early glottic cancer patients treated with a hypofractionated radiotherapy schedule of 60Gy in 20 fractions.
Material and Methods: This is a retrospective study of patients with stage I glottic cancer who received radical intent LINAC-based hypo-fractionated 3D conformal radiotherapy with a dose 60Gy in 20 fractions. The primary objective was to assess the locoregional control (LRC), and secondary objectives were to determine disease-free survival (DFS), overall survival (OS), and toxicity.
Results: The analysis included 105 patients from the age range of 35-88 years. About 69% of patients were over 60 years of age. The median overall treatment time (OTT) was 26 days (24 – 30 days). The mean follow-up was 74 months, ranging from 9 to 135 months. Seven patients had locoregional recurrence after an initial complete clinical response. Six had local, and one had a regional nodal recurrence. DFS at five years and ten years were 83% and 69%, and OS at five years and ten years were 87% and 80%, respectively. Most patients reported grade I skin reactions and tolerated the treatment well. We did not observe any late adverse events such as persistent laryngeal edema or radiation necrosis.
Conclusion: The radiotherapy schedule of 60Gy in 20 fractions over four weeks offers comparable local disease control with reasonable long-term side effects in T1 glottic cancer.
Keywords
Laryngeal Cancer
Early Glottic Cancer
T1 Cancer of Larynx
Radiotherapy
Hypofractionation Radiation Dose
Conformal Radiotherapy
Subjects
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Iranian Journal of Medical Physics
Volume 20, Issue 4
July and August 2023
Pages 226-232

  • Receive Date 25 January 2022
  • Revise Date 06 August 2022
  • Accept Date 14 August 2022