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Three-week hypofractionated radiotherapy in early glottic cancer – a single institution retrospective study

4 May 2022
Arun Sankar Sudha, Ravikumar Rejnish Kumar, Milan Anjanappa, Cessal Thomas Kainickal, Aleyamma Mathew, Ramadas Kunnambath

Background: Radiotherapy is a standard treatment option for early glottic carcinoma (stage I and II) with a fraction size of 2–2.2 Gy over 5–7 weeks. This study evaluates the outcome and prognostic factors of a 3-week hypofractionated treatment in early glottic malignancy.

Materials and Methods: The case records of 329 eligible patients with stage I and II glottic carcinoma recorded at the institution from 2003 to 2008 were retrospectively analysed. All patients were treated in a Cobalt-60 machine to a dose of 52.5 Gy in 15 fractions (3.5 Gy/fraction) over 3 weeks.

Results: Eighty-three percent had stage I disease. The local control rate at 5 years was 91.9%. On univariate analysis, stage I and II patients without subglottic extension had better local control. Disease extension to the subglottis fared poorly on multivariate analysis. After salvage treatment, the 5-year disease-free survival rate was 96.1% and the functional larynx preservation rate was 94.9% for stage I and 83.9% for stage II. The rate of severe complications was 2.1%.

Conclusion: Comparable results with low morbidity are achievable with a 3-week hypofractionation in early glottic cancers and it offers better patient convenience.

Highlights:

• In early glottic cancer, hypofractionated radiation provides excellent local control.

• Subglottic extension is a poor prognostic factor.

• 5-year disease-free survival rate of 96.1%.

• 5-year functional larynx preservation rate of 94.9%.

• Severe complication rate of 2.1%.

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