Abstract
The study was performed with 50 patients, 24 patients in Arm A and 26 patients in Arm B. Arm A—Conventional Telecobalt RT 66 Gy/33 fraction in stage T1N0M0 and stage T2N0M0 and Arm B—3D-CRT 66 Gy/33 fraction in T1N0M0 and T2N0M0 used. At the end of RT, 6 weeks, 3 months acute and late toxicities were noted by RTOG/EORTC morbidity scoring criteria for skin reaction, dysphagia and laryngeal toxicity. Fiber optic Laryngoscopy clinical assessment criteria were used to assess response after 6 weeks, 3 months of treatment completion. At 6 weeks of follow-up—Both Arm A and B complete response rate were 83.3% and 88.5% respectively and at 3 months rate were 85.0% and 95.7% respectively. There was no superiority of results with 3D-CRT over 2DRT. At the end of RT dysphagia grade 3 toxicity seen 1 patient (4.2%) but in Arm B (total 26 patients) no grade 3 toxicity found. At the end of 6 week and 3 month, one patient (4.3%) had grade 3 toxicity on Arm B only at 3 month. All these results are comparable. At the end of RT, one patient (3.8%) had incidentally dermatitis grade 3 toxicity in Arm B only. But all the results are comparable. On follow up, 6 week and 3 months, no grade 3 toxicity noted. At the end of RT, grade 3 laryngeal toxicity noted in 3 (12.5%) in Arm A and 2 (7.7%) in Arm B, not statistically significant. At 6 week, grade 3 toxicity found in 3/24 (12.5%) in Arm A and 2/26 (7.7%) in Arm B, at 3 months, 1/26 (4.3%) patient had incidental grade 3 toxicity only in Arm B. As conformal radiotherapy is more time consuming, less available in India and more costly than 2DRT, we can consider Conventional 2D planning for patients in India where most of people belong to low economic profile. Due to limitation in sample size and long-term follow-up further randomized studies are needed to validate the results.
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References
Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ (2003) Cancer statistics, 2003. CA Cancer J Clin 53:5–26
http://gco.iarc.fr/today/data/factsheets/populations/356-india-fact-sheets.pdf. Accessed 12 Aug 2019
Pfister DG, Laurie SA, Weinstein GS et al (2006) American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 24(22):3693–3704 (Epub 2006 Jul 10)
Fung K et al (2001) Effects of head and neck radiation therapy on vocal function. J Otolaryngol 30(3):133–139
Chera BS, Amdur RJ, Morris CG et al (2010) T1N0 to T2N0 squamous cell carcinoma of the glottic larynx treated with definitive radiotherapy. Int J Radiat Oncol Biol Phys 78(2):461–466
Mendenhall WM, Werning JW, Hinerman RW et al (2004) Management of T1–T2 glottic carcinomas. Cancer 100(9):1786–1792
Gracia-Serra A, Hinerman RW, Amdur RJ et al (2002) Radiotherapy for carcinoma in situ true vocal cords. Head Neck 24(4):390–394
Dragoni G, Milani F, Viganotti G et al (1971) Telecobalt therapy as an unique treatment of laryngeal neoplasia. Tumori 57(6):397–409
Marks RD Jr, Fitz-Hugh GS, Constable WC et al (1971) Fourteen years’ experience with cobalt-60 radiation therapy in the treatment of early cancer of the true vocal cords. Cancer 28(3):571–576
Hibbs GG, Hendrickson FR (1966) Telecobalt therapy of early malignant tumors of vocal cord. Radiology 86(3):447–449
https://en.wikibooks.org/wiki/Radiation_Oncology/Toxicity_grading/RTOG. Accessed 12 Aug 2019
https://www.rtog.org/ResearchAssociates/AdverseEventReporting/RTOGEORTCLateRadiationMorbidityScoringSchema.aspx. Accessed 12 Aug 2019
Fu KK, Pajak TF, Trotti A et al (2000) A radiation therapy oncology group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003. Int J Radiat Oncol Biol Phys 48(1):7–16
Osman SO, Astreinidou E, de Boer HC et al (2012) IMRT for image-guided single vocal cord irradiation. Int J Radiat Oncol Biol Phys 82(2):989–997
Jorgensen K, Sell A (1971) Carcinoma of the larynx: 11. Treatment by 60Co supervoltage irradiation. Acta Radiol Ther Phys Biol 10:161
Shinha PP (1987) Radiation therapy in early carcinoma of the true vocal cords (stage I and 11). Int J Radiat Oncol Biol Phys 13:1635
Skolyszewski J, Reinfuss M, Kowalska T (1984) Results of radiation therapy in carcinoma of the larynx. Acta Radiol Oncol 23:415
Van den Bogaert W, Ostyn F, Van der Schueren E (1982) Glottic carcinoma limited to the vocal cords. Acta Radiol Oncol 21:33
Inoue T et al (1983) Tumor response and local control after radiation therapy of Tinomo glottic arcinoma. Nippon Act radio1 43:13
Jones AS, Fish B, Fenton JE et al (2004) The treatment of early laryngeal cancers (T1–T2 N0): surgery or irradiation? Head Neck 26(2):127–135
Lim YJ et al (2015) Long-term outcome of definitive radiotherapy for early glottic cancer: prognostic factors and patterns of local failure. Cancer Res Treat 47(4):862–870
Lee JH et al (2001) Radiotherapy with 6-megavolt photons for early glottic carcinoma: potential impact of extension to the posterior vocal cord. Am J Otolaryngol 22(1):43–54
Izuno I et al (2009) Treatment of early vocal cord carcinoma with 60Co Gamma Rays, 8/10 MV x-rays, or 4 MV x-rays—are the results different? Acta Oncologica 29(5):637–639
Fein DA et al (1996) Do overall treatment time, field size, and treatment energy influence local control of T1–T2 squamous cell carcinomas of the glottic larynx? Int J Radiat Oncol Biol Phys 34(4):823–831
Foote RL et al (1996) Radiation therapy for glottic cancer using 6-MV photons. Cancer 77:381–386
Akine Y et al (1991) Radiotherapy of T1 glottic cancer with 6 MeV xrays. Int J Radiat Oncol Biol Phys 20:1215–1218
Rudoltz MS et al (1993) Prognostic factors for local control and survival in TI squamous cell carcinoma of the glottis. Int J Radiat Oncol Biol Phys 26(5):767–772
Hayakawa K, Mitsuhashi N, Akimoto T et al (1996) The effect of overall treatment time of radiation therapy on local control of T1-stage squamous cell carcinoma of the glottis. Laryngoscope 106(12 Pt 1):1545–1547
Tong C-C, Au K-H, Ngan RK et al (2012) Definitive radiotherapy for early stage glottic cancer by 6 MV photons. Head Neck Oncol 4:23
Kim TG et al (2012) Definitive radiation therapy for early glottic cancer: experience of two fractionation schedules. Clin Exp Otorhinolaryngol 5(2):94–100
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Mandal, S., Chaudhuri, T. & Mukhopadhyay, D. Prospective Observational Comparative Study of Response and Toxicities in Early Glottic Cancer Using Telecobalt Versus 3D-CRT. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 1725–1734 (2022). https://doi.org/10.1007/s12070-019-01729-4
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DOI: https://doi.org/10.1007/s12070-019-01729-4