Hypofractionated Radiotherapy for Stage I Squamous Cell Carcinoma Glottis: An Experience with ۶۰Gy in ۲۰ Fractions

Introduction: Early-stage glottic cancer has a high cure rate with definitive radiotherapy. Historical reports show excellent local control. The present study evaluated the outcomes of early glottic cancer patients treated with a hypofractionated radiotherapy schedule of ۶۰Gy in ۲۰ fractions.Material and Methods: This is a retrospective study of patients with stage I glottic cancer who received radical intent LINAC-based hypo-fractionated ۳D conformal radiotherapy with a dose ۶۰Gy in ۲۰ fractions. The primary objective was to assess the locoregional control (LRC), and secondary objectives were to determine disease-free survival (DFS), overall survival (OS), and toxicity.Results: The analysis included ۱۰۵ patients from the age range of ۳۵-۸۸ years. About ۶۹% of patients were over ۶۰ years of age. The median overall treatment time (OTT) was ۲۶ days (۲۴ – ۳۰ days). The mean follow-up was ۷۴ months, ranging from ۹ to ۱۳۵ months. Seven patients had locoregional recurrence after an initial complete clinical response. Six had local, and one had a regional nodal recurrence. DFS at five years and ten years were ۸۳% and ۶۹%, and OS at five years and ten years were ۸۷% and ۸۰%, respectively. Most patients reported grade I skin reactions and tolerated the treatment well. We did not observe any late adverse events such as persistent laryngeal edema or radiation necrosis.Conclusion: The radiotherapy schedule of ۶۰Gy in ۲۰ fractions over four weeks offers comparable local disease control with reasonable long-term side effects in T۱ glottic cancer.

Keywords:

Laryngeal cancer , Early Glottic cancer , T۱ Cancer of Larynx , Radiotherapy , Hypofractionation Radiation Dose , Conformal Radiotherapy