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

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