Departmental Bulletin Paper Optimized treatment strategy of radiotherapy for early glottic squamous cell carcinomas : An initial analysis

Kimura, Kana  ,  Itoh, Yoshiyuki  ,  Okada, Tohru  ,  Kubota, Seiji  ,  Kawamura, Mariko  ,  Nakahara, Rie  ,  Oie, Yumi  ,  Kozai, Yuka  ,  Takase, Yuuki  ,  Tsuzuki, Hidenori  ,  Nishio, Naoki  ,  Hiramatsu, Mariko  ,  Fujimoto, Yasushi  ,  Mizutani, Takefumi  ,  Naganawa, Shinji

79 ( 3 )  , pp.331 - 338 , 2017-08 , Nagoya University Graduate School of Medicine, School of Medicine
The purpose of this study was to evaluate the clinical outcomes of radiotherapy for patients with T1/T2 glottic carcinoma. Patients with T1/T2 glottic carcinoma histopathologically diagnosed with squamous cell carcinoma and treated at our hospital between 2007 and 2015 were analyzed retrospectively. Our strategy for T1/T2 glottic carcinoma was as follows: radiotherapy alone with 2.25 Gy per fraction to a total of 25–28 fractions for patients with non-bulky T1 glottic carcinoma; concurrent chemoradiotherapy with oral S-1 and radiotherapy with 2 Gy per fraction to a total of 30 fractions for patients with T1 bulky/T2 favorable glottic carcinoma; or chemoradiotherapy with high-dose cisplatin and radiotherapy with 2 Gy per fraction to a total of 35 fractions for T2 unfavorable glottic carcinoma. Forty-eight patients were eligible. The median follow-up period among surviving patients was 38 months (range, 11–107). The disease was T1a in 23%, T1b in 13%, and T2 in 65% of patients. The 3-year local control rate in all patients, T1a, T1b, and T2 was 96.7%, 100%, 100%, and 96.0%, respectively. Of the 46 patients, one with T2 glottic carcinoma developed recurrent disease at the primary site, and one with T2 glottic carcinoma had lymph node recurrences in the neck. Acute Grade 3 dermatitis occurred in 8 (17%) patients and late Grade 2 hypothyroidism occurred in 2 (4%) patients. This retrospective study shows that our optimized treatment strategy of radiotherapy depending on the stage of early glottic carcinoma is not only effective but also well-tolerated.

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