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

B.G. Salas Salas; D.J. Domínguez Nuez; R. Cabrera; L. Ferrera Alayón; Marta Lloret Sáez-Mravo; Pedro Lara Jiménez

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

B. G. Salas-Salas ^[2] ; D. J. Domínguez-Nuez ^[1] ; R. Cabrera ^[2] ; L. Ferrera-Alayón ^[2] ; M. Lloret ^[2] ; P. C. Lara ^[3]
1. [1] Universidad de Las Palmas de Gran Canaria
  
  Universidad de Las Palmas de Gran Canaria
  
  Gran Canaria, España
2. [2] Radiation Oncology Department, Hospital Dr. Negrín, Las Palmas de Gran Canaria
3. [3] Universidad Fernando Pessoa Canarias
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Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 1, 2020, págs. 151-157
Idioma: inglés
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Resumen
- 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.