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Radiotherapy for T1a glottic cancer: the influence of smoking cessation and fractionation schedule of radiotherapy

  • Laryngology
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Abstract

The objective of the presented study is to report on retrospectively collected data on long-term outcome and toxicity and prospective assessment of quality of life (QoL) and Voice-Handicap Index (VHI) of patients with T1a glottic cancer treated with radiotherapy. Between 1985 and 2011, 549 patients were treated. Endpoints were local control (LC), toxicity, QoL and VHI. After a median follow-up of 93 months, the actuarial rates of LC were 91, and 90 % at 5- and 10-years, respectively. Continuing smoking (p < 0.001) and anaemia (p = 0.02) were significantly correlated with poor LC on univariate analysis and fractionation schedule did not show significant correlation (p = 0.08). On multivariate analysis, only continuing smoking retained significance (p = 0.001). These patients had also significantly increased incidence of second primary tumour and lower overall survival rates. The incidence of grade ≥2 late xerostomia and dysphagia were 10 and 6 %, respectively. Slight and temporary deterioration of QoL-scores was reported. The scores on the EROTC-QOL-H&N35 dysphagia and xerostomia at 24 months were -2 and -3, compared to baseline, respectively. VHI improved significantly from 34 at baseline to 21 at 24 months. Patients who continued smoking had significantly worse VHI. In conclusion, excellent outcome with good QoL and VHI were reported. Patients who continued smoking after radiotherapy had significantly poor LC and worse VHI. The current study emphasizes the importance of smoking cessation and the non-inferiority of hypofractionated schemes in terms of outcome and VHI. At our institution, phase II study is going to evaluate the role of single vocal cord irradiation with high fraction dose.

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References

  1. www.oncoline.nl/larynxcarcinoom

  2. Hartl DM, Ferlito A, Brasnu DF, Langendijk JA, Rinaldo A, Silver CE, Wolf GT (2011) Evidence-based review of treatment options for patients with glottic cancer. Head Neck 11:1638–1648

    Article  Google Scholar 

  3. Rosen CA, Lee AS, Osborne J, Zullo T, Murry T (2004) Development and validation of the voice handicap index-10. Laryngoscope 114:1549–1556

    Article  PubMed  Google Scholar 

  4. Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB (2004) Management of T1–T2 glottic carcinomas. Cancer 100:1786–1792

    Article  PubMed  Google Scholar 

  5. van Loon Y, Sjögren EV, Langeveld TP, Baatenburg de Jong RJ, Schoones JW, van Rossum MA (2012) Functional outcomes after radiotherapy or laser surgery in early glottic carcinoma: a systematic review. Head Neck 34:1179–1189

    Article  PubMed  Google Scholar 

  6. Cohen SM, Garrett CG, Dupont WD, Ossoff RH, Courey MS (2006) Voice-related quality of life in T1 glottic cancer: irradiation versus endoscopic excision. Ann Otol Rhinol Laryngol 115:581–586

    PubMed  Google Scholar 

  7. Sjogren EV, van Rossum MA, Langeveld TPM, Voerman MS, van de Kamp VA, Friebel MO, Wolterbeek R, Baatenburg de Jong RJ (2008) Voice outcome in T1a midcord glottic carcinoma: laser surgery vs radiotherapy. Arch Otolaryngol Head Neck Surg 134:965–972

    Article  PubMed  Google Scholar 

  8. Sjögren EV, van Rossum MA, Langeveld TP, Voerman MS, van de Kamp VA, Baatenburg de Jong RJ (2009) Voice profile after type I or II laser chordectomies for T1a glottic carcinoma. Head Neck 31:1502–1510

    Article  PubMed  Google Scholar 

  9. Terhaard CH, Snippe K, Ravasz LA, van der Tweel I, Hordijk GJ (1991) Radiotherapy in T1 laryngeal cancer: prognostic factors for locoregional control and survival, uni- and multivariate analysis. Int J Radiat Oncol Biol Phys 21:1179–1186

    Article  CAS  PubMed  Google Scholar 

  10. Van der voet JC, Keus RB, Hart AA, Hilgers FJ, Bartelink H (1998) The impact of treatment time and smoking on local control and complications in T1 glottic cancer. Int J Radiat Oncol Biol Phys 42:247–255

    Article  CAS  PubMed  Google Scholar 

  11. Overgaard J, Hansen HS, Specht L, Overgaard M, Grau C, Andersen E, Bentzen J, Bastholt L, Hansen O, Johansen J, Andersen L, Evensen JF (2003) Five compared with six fractions per week of conventional radiotherapy of squamous-cell carcinoma of head and neck: DAHANCA 6 and 7 randomised controlled trial. Lancet 362:933–940

    Article  PubMed  Google Scholar 

  12. Laskar SG, Baijal G, Murthy V, Chilukuri S, Budrukkar A, Gupta T, Agarwal JP (2012) Hypofractionated radiotherapy for T1N0M0 glottic cancer: retrospective analysis of two different cohorts of dose-fractionation schedules from a single institution. Clin Oncol 24:e180–e186

    Article  CAS  Google Scholar 

  13. Wiernik G, Alcock CJ, Bates TD, Brindle JM, Fowler JF, Gajek WR, Goodman S, Haybittle JL, Henk JM, Hopewell JW (1991) Final report on the second British Institute of Radiology fractionation study: short versus long overall treatment times for radiotherapy of carcinoma of the laryngopharynx. Br J Radiol 64:232–241

    Article  CAS  PubMed  Google Scholar 

  14. Gowda RV, Henk JM, Mais KL, Sykes AJ, Swindell R, Slevin NJ (2003) Three weeks radiotherapy for T1 glottic cancer: the Christie and royal marsden hospital experience. Radiother Oncol 682:105–111

    Article  Google Scholar 

  15. Osman SOS, Astreinidou E, De Boer HCJ, Keskin-Cambay F, Breedveld S, Voet P, Al-Mamgani A, Heijmen BJ, Levendag PC (2012) IMRT for image-guided single vocal cord irradiation. Int J Radiat Oncol Biol Phys 2012(82):989–997

    Article  Google Scholar 

  16. Warde P, O’Sullivan B, Bristow RG, Panzarella T, Keane TJ, Gullane PJ, Witterick IP, Payne D, Liu FF, McLean M, Waldron J, Cummings BJ (1998) T1/T2 glottic cancer managed by external beam radiotherapy: the influence of pretreatment haemoglobin on local control. Int J Radiat Oncol Biol Phys 41:347–353

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Abrahim Al-Mamgani.

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Al-Mamgani, A., van Rooij, P.H., Mehilal, R. et al. Radiotherapy for T1a glottic cancer: the influence of smoking cessation and fractionation schedule of radiotherapy. Eur Arch Otorhinolaryngol 271, 125–132 (2014). https://doi.org/10.1007/s00405-013-2608-8

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  • DOI: https://doi.org/10.1007/s00405-013-2608-8

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