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

• Published in: Nagoya journal of medical science 2017-08, Vol.79 (3), p.331-338
• Main Authors: 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
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Glottis - pathology; Humans; Laryngeal Neoplasms - radiotherapy; Male; Middle Aged; Neoplasm Recurrence, Local; Original Paper
• ISSN: 0027-7622; 2186-3326
• DOI: 10.18999/nagjms.79.3.331

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.