Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation.


Journal

The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378

Informations de publication

Date de publication:
01 2020
Historique:
received: 20 06 2018
revised: 19 01 2019
accepted: 28 01 2019
pubmed: 14 2 2019
medline: 3 7 2020
entrez: 14 2 2019
Statut: ppublish

Résumé

We aim to report oncologic outcomes after conventional radiotherapy (ConRT) using opposed lateral beams and intensity-modulated radiation therapy (IMRT) for tumor (T)1 nodal (N)0 T1 N0 glottic squamous cell carcinoma. Retrospective case-control study. We retrospectively reviewed demographic, disease, and treatment characteristics for patients treated at our institution during 2000 to 2013. One hundred fifty-three patients (71%) were treated using ConRT and 62 (29%) using IMRT. The median follow-up for all patients was 68 months. There was no statistically significant difference in 5-year local control between patients with T1a versus T1b disease (94% vs. 89%, respectively, P = 0.5). Three-year locoregional control for patients treated with ConRT was 94% compared to 97% with IMRT (P = 0.4). Three-year overall survival (OS) for patients treated with ConRT was 92.5% compared with 100% with IMRT (P = 0.1). Twelve of 14 patients with local recurrence underwent salvage surgery with 5-year ultimate locoregional control of 98.5% and 97.1% in the ConRT and IMRT cohorts, respectively (P = 0.7). Multivariate analysis showed age < 60 years (P < 0.0001) and pretreatment Eastern Cooperative Oncology Group performance status <2 (P = 0.0022) to be independent correlates of improved OS. Postradiation cerebrovascular events were in four patients in the ConRT cohort (3%), whereas no patients in the IMRT cohort suffered any events. Because the oncologic outcomes for patients treated with IMRT were excellent and IMRT allows for carotid sparing, we have transitioned to IMRT as our standard for most patients with T1 glottic cancer. 3b Laryngoscope, 130:146-153, 2020.

Identifiants

pubmed: 30756394
doi: 10.1002/lary.27873
pmc: PMC6895404
mid: NIHMS1047882
doi:

Types de publication

Comparative Study Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

146-153

Subventions

Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Organisme : NIDCR NIH HHS
ID : R01 DE025248
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA214825
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA218148
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA225190
Pays : United States

Informations de copyright

© 2019 The American Laryngological, Rhinological and Otological Society, Inc.

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Auteurs

Abdallah S R Mohamed (ASR)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
Department of Clinical Oncology, University of Alexandria, Alexandria, Egypt.

Blaine D Smith (BD)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
University of Texas McGovern Medical School, The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, U.S.A.

Joshua B Smith (JB)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
University of Texas McGovern Medical School, The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, U.S.A.

G Brandon Gunn (GB)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Adam S Garden (AS)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Steven J Frank (SJ)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

William H Morrison (WH)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Jack Phan (J)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Mark Zafereo (M)

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Heath Skinner (H)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Stephen Y Lai (SY)

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Katherine A Hutcheson (KA)

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Jan S Lewin (JS)

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Amy E Hessel (AE)

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Apurva A Thekdi (AA)

Department of Otolaryngology, Houston Methodist Hospital, Houston, Texas, U.S.A.

Randal S Weber (RS)

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Clifton D Fuller (CD)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
Medical Physics Program, The University of Texas Graduate School of Biomedical Sciences, Houston, Texas, U.S.A.

David I Rosenthal (DI)

Multidisciplinary Larynx Cancer Working Group from the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

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