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

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Abstract

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.

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Authors and Affiliations

  1. Radiation Oncology Department, Hospital Dr. Negrín, 35070, Las Palmas de Gran Canaria, Spain

    B. G. Salas-Salas, R. Cabrera, L. Ferrera-Alayón & M. Lloret

  2. Universidad de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

    D. J. Domínguez-Nuez & M. Lloret

  3. Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain

    P. C. Lara

  4. Oncology Department, Hospital Universitario San Roque, Las Palmas de Gran Canaria, Spain

    P. C. Lara

Authors
  1. B. G. Salas-Salas
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  3. R. Cabrera
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  4. L. Ferrera-Alayón
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  5. M. Lloret
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Correspondence to B. G. Salas-Salas.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethic Committee in medical research of the HUGCDN, following the General Health Law 14/86, the Organic Law of data protection 15/99 and the Royal Decree 1090/2015, and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study. Patients were followed prospectively under the Spanish RD 1566/1998 regulation for Radiotherapy Quality Assurance.

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Salas-Salas, B.G., Domínguez-Nuez, D.J., Cabrera, R. et al. Hypofractionation vs. conventional radiotherapy fractionation in the conservative treatment of T1 glottic cancer: a prospective cohort study. Clin Transl Oncol 22, 151–157 (2020). https://doi.org/10.1007/s12094-019-02118-7

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