T1N0/T2N0 glottic carcinoma: A comparison of two fractionation schedules

Summary The aim of this paper is the retrospective comparison of accelerated/hypofractionated radiotherapy regimen (AHFX) with standard fractionation regimen (SFX) for patients with early glottic carcinoma. One hundred and forty-five patients with T1–T2 glottic cancer between 1986 and 1998 were eligible. Before 1992, patients received 60–66 Gy in 30–33 fractions over 6–6.5 weeks (SFX) with 60Co and 6-MV beams. After 1992, patients received 52.5–55 Gy in 20 fractions over 4 weeks (AHFX) using 6-MV beams. The end-points were overall survival, laryngectomy-free survival (LFS), loco-regional control and toxicity. One hundred and two were stage T1N0; 43 were stage T2N0. Median follow up was 4.9 years. The 5-year overall survival was 78%. Five-year loco-regional control in T1N0 patients was higher in AHFX than in SFX group (95 vs 75%, P = 0.002). Loco-regional control in T2N0 patients was similar for AHFX and SFX (81 vs 80%, P = 0.813). Overall LFS was 88%. T1N0 AHFX patients had 5-year LFS of 95% compared with 75% for SFX (P = 0.003). For T2N0 AHFX patients, overall LFS was 92% compared with 80% for the SFX group (P = 0.291). No grade 4 or 5 late toxicity occurred. One AHFX patient developed grade 3 toxicity; two of 51 SFX patients developed grade 2 toxicity versus five of 94 AHFX patients. AHFX using 6-MV beams for treatment of early glottic cancer resulted in equivalent LFS and toxicity when compared with SFX.