Cc. Wang et al., ROLE OF ACCELERATED FRACTIONATED-IRRADIATION FOR SUPRAGLOTTIC CARCINOMA - ASSESSMENT OF RESULTS, The cancer journal from Scientific American, 3(2), 1997, pp. 88-91
PURPOSE We evaluated the results of locoregional control, patients' re
lapse-free survival, and voice preservation in patients with supraglot
tic carcinoma treated with accelerated radiation therapy. PATIENTS AND
METHODS The records of 164 patients undergoing accelerated fractionat
ed radiation therapy for carcinoma of the supraglottis from 1981 to 19
92 were reviewed and evaluated for locoregional control, disease-speci
fic survival, and rates of voice preservation. All patients were treat
ed with 1.6 Gy per fraction two fractions a day (BID) for 67.2 to 70.0
Gy in 6 weeks. The median follow-up was 56 months. Due to severe acut
e mucosal toxicity, all patients were given a short treatment break af
ter 38.4 to 48.0 Gy. RESULTS For T1, T2, T3, and T4 tumors, the 5-year
actuarial local control rates were 96%, 86%, 76%, and 43%, respective
ly, and relapse-free survival rates were 78%, 82%, 64%, and 40%, respe
ctively. With surgical salvage, the corresponding ultimate local contr
ol rates for the T1, T2, T3, and T4 tumors were 96%, 33%, 88%, and 51%
, respectively. Regional control by T and N stage was nonsignificant.
Voice preservation rates for the T1, T2, T3, and T4 tumors were 96%, 8
0%, 72%, and 43%, respectively, and for the entire group the rate was
79%. CONCLUSIONS Accelerated fractionated radiation therapy resulted i
n excellent locoregional control, relapse-free survival, and voice pre
servation rates for patients with supraglottic carcinoma The T stage a
nd N stage were significant predictors of outcome. T4 tumors and node-
positive neck disease portended a poor prognosis. These results as com
pared to our historical control and the published data in the literatu
re with conventional once-daily radiation therapy (QD) suggested impro
ved local control and patient survival after accelerated fractionated
BID radiation therapy. For confirmation of these results, a prospectiv
e randomized trial is needed.