Ms. Rudoltz et al., PROGNOSTIC FACTORS FOR LOCAL-CONTROL AND SURVIVAL IN T1 SQUAMOUS-CELLCARCINOMA OF THE GLOTTIS, International journal of radiation oncology, biology, physics, 26(5), 1993, pp. 767-772
Citations number
22
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: To evaluate the effect of host, tumor, and treatment-related
variables on local control and survival in patients with T1N0M0 squamo
us cell carcinoma of the glottis. Materials and Methods: Ninety-one pa
tients with T1N0M0 squamous cell carcinoma of the glottic larynx were
analyzed. Median follow-up was 9 years (range 2-25). Patients were tre
ated with daily fractions of 180 cGy to 220 cGy to doses of 5925-7000
cGy (median 6400). The following factors were analyzed: age, sex, hist
ologic grade, disease extent, beam energy, field size, total dose, dos
e per fraction, and elapsed treatment days. Results: The 5-year actuar
ial local control was 80%. On univariate analysis, only elapsed treatm
ent days and dose per fraction were significant factors for local cont
rol. Local control was 100% if treatment was completed within 42 days,
91% for 43-46 days, 74% for 47-50 days, 65% for 51-54 days, and 50% f
or 55-66 days (p = 0.0001). In patients treated at < 200 cGy per fract
ion, local control was 62% as compared to 87% for greater-than-or-equa
l-to 200 cGy per fraction (p = 0.006). On multivariate analysis, only
elapsed treatment days was a significant factor for local control (p =
0.0001). The 5-year actuarial survival for the whole group was 92%. E
lapsed treatment days was the only variable affecting survival. Surviv
al was 100% if treatment was delivered within 42 days, 96% for 43-46 d
ays, 94% for 47-50 days, 91% for 51-54 days, and 67% for 55-66 days (p
= 0.02). The 5-year actuarial disease-specific survival was 95%, with
treatment duration again being the only significant prognostic factor
. Disease-specific survival was 97% for treatment completed within 39-
54 days versus 80% for 55-66 days (p = 0.02). Only three (3.3%) patien
ts experienced moderate or severe complications. None of the evaluated
parameters impacted significantly on complications. Conclusion: We co
nclude that elapsed days is the most prognostically significant factor
for local control and survival in patients treated with radiotherapy
for T1 squamous cell carcinoma of the glottis. We recommend that these
patients be treated with 210 cGy daily fractions to 6300 cGy.