ROLE OF ACCELERATED FRACTIONATED-IRRADIATION FOR SUPRAGLOTTIC CARCINOMA - ASSESSMENT OF RESULTS

Citation
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
Citations number
19
Categorie Soggetti
Oncology
ISSN journal
10814442
Volume
3
Issue
2
Year of publication
1997
Pages
88 - 91
Database
ISI
SICI code
1081-4442(1997)3:2<88:ROAFFS>2.0.ZU;2-V
Abstract
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.