Radiotherapy alone is often used to treat early-stage glottic cancer (ESGC), a cancer of the vocal chords, however, the optimal radiation treatment schedule remains unknown. Both hypofractionated radiotherapy (HFX) and conventionally-fractionated radiotherapy (CFX) 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 HFX versus CFX for ESGC using a large national database.
The study was published today in the Journal of the National Cancer Institute. The Yale Cancer Center research team used clinical data from 10,212 patients diagnosed with stage 1 or 2 glottic cancer from 2004-2013. 4,030 patients (39.5%) received HFX and 6,182 patients (60.5%) received CFX.
The study found that HFX is associated with improved survival compared to CFX among patients treated with definitive radiotherapy for ESGC, particularly among patients with stage 2 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 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 ESGC 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 HFX has had increased utilization on a national level and subsequently, impacted overall survival for patients with ESGC.
Additional study authors include, Trevor J. Bledsoe MD, Henry S. Park MD MPH, John M. Stahl MD, Wendell G. Yarbrough MD MMHC FACS, Barbara A. Burtness MD and Roy H. Decker MD PhD.