Hypofractionated Radiotherapy vs Conventionally Fractionated Radiotherapy in Early-Stage Glottic Cancer
Radiotherapy alone is often used to treat early-stage glottic cancer. However, the optimal radiation treatment schedule remains unknown. Both hypofractionated radiotherapy and conventionally fractionated radiotherapy are recommended treatment options. In an attempt to compare differences in overall survival between the two approaches a team of Yale Cancer Center researchers compared treatment patterns among patients treated with hypofractionated vs conventionally fractionated radiotherapy for ESGC using a large national database. Their findings were published by Bledsoe et al in the Journal of the National Cancer Institute.
Study Findings
The Yale research team used clinical data from 10,212 patients diagnosed with stage I or II glottic cancer from 2004–2013. 4,030 patients (39.5%) received hypofractionated radiotherapy and 6,182 patients (60.5%) received conventionally fractionated radiotherapy. The study found that hypofractionated radiotherapy is associated with improved survival compared to conventionally fractionated radiotherapy among patients treated with definitive radiotherapy for ESGC, particularly among patients with stage II disease.
“This is an important finding, as the optimal fractionation for early-stage glottic cancer has long been an area of controversy. These results strongly support hypofractionation as a preferred treatment approach. It is also reassuring to that our results show the utilization of hypofractionation has been increasing considerably,” said Zain A. Husain, MD, Assistant Professor of Therapeutic Radiology, Director of the Head and Neck Radiotherapy Program at Smilow Cancer Hospital, and lead author of the study.
Identifying an optimal radiation regimen for patients with early-stage glottic cancer is important, since failure to control disease locally with radiation often leads to attempts at surgical salvage, which may involve a total laryngectomy.
The results of this study demonstrate that hypofractionated radiotherapy has had increased utilization on a national level—patients treated with hypofractionated radiotherapy increased from 22.1% in 2004 to 58.0% in 2013—and, subsequently, impacted overall survival for patients with early-stage glottic cancer.
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