Definitive radiation therapy for moderately advanced laryngeal cancer: effects of accelerated hyperfractionation.
OBJECTIVE
The purpose of this retrospective study was to analyze the results of accelerated hyperfractionation for patients with moderately advanced (T2 and T3) laryngeal cancer.


METHODS
Between 1998 and 2007, 9 supraglottic carcinomas (6 T2N0M0, 2 T2N2M0, 1 T3N0M0), 30 glottic carcinomas (25 T2N0M0, 5 T3N0M0), and 1 T2N0M0 subglottic carcinoma were treated with definitive radiotherapy using accelerated hyperfractionation without concurrent chemotherapy. The dose-fractionation for 35 patients was 72.8 Gy/56 fractions/5.6 weeks, and that for four patients treated between 1998 and 2001 was 72 Gy/60 fractions/6 weeks. One patient who had been treated with steroid therapy for systemic lupus erythematosus was treated by 67.8 Gy/44 fractions/4.4 weeks.


RESULTS
The local control and overall survival probabilities at 5 years for supraglottic carcinomas were 75% and 86%, respectively. Those for glottic carcinomas were 80% and 92%, respectively. The 5-year local control probabilities for T2 and T3 tumors were 85% and 56%, respectively. This excellent local control rate especially for T2 laryngeal carcinomas may be attributable to the effect of accelerated hyperfractionation. No late toxicities of grade 2 or more was noted among the 39 patients treated with 72.8 Gy/56 fractions or 72 Gy/60 fractions.


CONCLUSIONS
Accelerated hyperfractionation of 72.8 Gy/56 fractions/5.6 weeks using 1.3 Gy/fraction seems a safe and effective dose-fractionation for patients with moderately advanced laryngeal carcinomas.
Department of Radiology, Tokyo Medical University Hachioji Medical Center, 1663 Tatemachi, Hachioji city, Tokyo 193-0998, Japan. okubo@tokyo-med.ac.jp
Mitsuru
M
Okubo
Yasumasa
Y
Nishimura
Toru
T
Shibata
Kiyoshi
K
Nakamatsu
Shuichi
S
Kanamori
Izumi
I
Tachibana
Ryuta
R
Koike
Tatsuyuki
T
Nishikawa
Kazunori
K
Mori
D000368:Aged; D000369:Aged, 80 and over; D003872:Dermatitis / Q000209:etiology; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004941:Esophagitis / Q000209:etiology; D005260:Female; D005931:Glottis / Q000473:pathology / Q000528:radiation effects*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome