Radiotherapy in 
Early Stage Glottic Cancer : Effect of Reduction of
Treatment Duration by Hypofractionation Treatment

Keimyung Medical Journal 2002;21(2):169-176.

Radiotherapy in Early Stage Glottic Cancer : Effect of Reduction of Treatment Duration by Hypofractionation Treatment

초기 성문암에서 방사선치료 : 소분할조사법에 의한 치료기간 단축의 영향

김진희

Abstract

Early stage glottic cancer can be cured by radiation therapy alone with voice preservation. I undertook to study the effect of hypofractionation treatment; which shortens treatment duration by increasing the fraction size in early stage laryngeal cancer; when radiation therapy was performed. Thirty patients with early stage (I; II) glottic cancer were treated with radiation therapy alone. The median age was 62; ranging from 43 to 73 years old. According to TNM stage; 21 patients were stage I; and nine were stage II. Mean total radiation doses were 63 Gy and 65 Gy with 2 Gy fraction in stage I and II in conventional treatment group; and 58 Gy and 62 Gy with 2.2 Gy fraction in stage I and II in hypofractionation group. Mean treatment durations were 46 days (39∼51) in conventional treatment group; and 39 days (35∼44) in hypofractionation group. The overall median follow-up period was 51.5 months with the range of 14 to 139 months. Local control rate was 96.6% (29/30) in all patients. Five year local relapse free survival rate (5YLRFS) was 83.3% in all patients; and 5YLRFS in stage I and II were 90% and 70% respectively. 5YLRFS in stage I and II of conventional treatment group were 100% and 71.4%; and 80% and 66.7% in stage I and II of hypofractionation group; having no statistical significance. Five (16%) patients; including one patient without local control; developed local failure after average 14 (5∼29) months; three of whom were salvaged by curative laryngectomy. There was no difference in the failure pattern between the conventional group and hypofractionation group. No patient suffered from above grade 3 acute and chronic complications. Total voice preservation was observed in 26 patients (86.6%). Although the present study was carried out with a small number of patients; there is no difference in local relapse free survival; failure pattern and complications between conventional treatment and hypofractionation groups which shortens the treatment time by increasing the fraction size from 2 Gy to 2.2 Gy. It is important to carry out radomized clinical study with a large number of patients.

Key Words: Conventional fractionation, Early stage glottic cancer, Local relapse free survival, Radiation therapy, Hypofractionation