T1-T2 carcinoma of the glottis: relative hypofractionation.
Radiation therapy, the preferred primary treatment for early squamous cell carcinoma of the glottis, offers high local control rates with voice preservation; however, the optimal treatment schedule is subject to debate. Local control, with and without surgical salvage, and associated long-term effects and complications were retrospectively analyzed in 90 patients treated with definitive radiation therapy for T1-T2 squamous cell carcinoma of the glottis. Patients received three weekly fractions of 333 cGy to a total dose of 60 Gy in 6 weeks. Median follow-up was 51.5 months. With radiation therapy alone, local control was 92% for T1 disease and 88% for T2; with surgical salvage, the control rate was 99%. Long-term effects included moderate hoarseness (16% of patients) and moderate or severe laryngeal edema (10% of patients). In seven patients who underwent salvage surgery, the complication rate was 29%. Despite excellent local control, this regimen may produce more long-term effects and complications than conventional fractionation.
Randall
M E
ME
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Springer
D J
DJ
Raben
M
M
D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D008722:Methods; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012189:Retrospective Studies