Hypofractionation vs. conventional radiotherapy fractionation in the conservative treatment of T1 glottic cancer: a prospective cohort study

• Published in: Clinical & translational oncology 2020, Vol.22 (1), p.151-157
• Main Authors: Salas-Salas, B. G., Domínguez-Nuez, D. J., Cabrera, R., Ferrera-Alayón, L., Lloret, M., Lara, P. C.
• Format: Article
• Language: English
• Subjects: Brief Research Article; Medicine; Medicine & Public Health; Oncology
• ISSN: 1699-048X; 1699-3055
• DOI: 10.1007/s12094-019-02118-7

Background Definitive radiotherapy is an effective single-modality in T1 glottic cancer. Hypofractionated schemes could offer excellent results in a shorter treatment period. We aimed to evaluate the clinical outcomes and toxicity comparing conventional vs. hypofractionated radiotherapy treatment in T1N0M0-glottic cancer. Patients and Methods Between Jan-1st, 2005 and August-1st, 2017, in a prospective cohort study, with 10-year follow-up, 138 patients were treated with conventional schedule 2 Gy/day, total dose 70 Gy/7 weeks ( N  = 71) or hypofractionated schedule 2, 2–2, 25 Gy/day, total dose 63, 8–63 Gy/5, 5 weeks ( N  = 67). Endpoints were clinical-response rate, local relapse-free survival (LRFS), laryngectomy-free survival (LFS), toxicity rates, relapse-free survival (RFS), metastasis-free survival (MFS), second tumour-free survival (2TFS), and overall survival (OS). Results All patients showed a complete clinical response. No differences were found for LRFS ( p  = 0.869), LFS ( p  = 0.975), RFS ( p  = 0.767), MFS ( p  = 0.601), 2TFS ( p  = 0.293), or OS ( p  = 0.685). Acute toxicity for skin and mucosae was similar ( p  = 0.550 and p  = 0.698). Acute laryngeal toxicity was higher in the hypofractionation group ( p  = 0.004), due to an increase in slight moderate grade. No differences in late laryngeal edema were found ( p  = 0.989). Conclusion Radiotherapy offers high rate survival, local control, and larynx preservation after 5–10-year follow-up. A hypofractionation could be preferable, since it offers the same results as conventional with fewer treatment sessions.