Targeting Anterior Commissure Involvement with Hyperfractionated Radiotherapy for T1–T2 Squamous Cell Carcinoma of the Glottic Larynx

Cancers Pub Date : 2024-05-12 DOI:10.3390/cancers16101850
Satoshi Seno, K. Iwashita, Akifumi Kajiwara, Rie Sasaki, Tatsuya Furukawa, M. Teshima, H. Shinomiya, Naomi Kiyota, Rod Lynch, Kenji Yoshida, T. Ishihara, D. Miyawaki, K. Nibu, Ryohei Sasaki
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Abstract

Anterior commissure is involved in about 20% of early-stage glottic squamous cell carcinomas (EGSCCs). Treatment outcomes and prognostic factors for EGSCC with anterior commissure involvement (ACI) were evaluated by focusing on hyperfractionated radiotherapy (74.4 Gy in 62 fractions). One-hundred and fifty-three patients with T1–T2 EGSCC were included in this study. The median total doses for T1a, T1b, and T2 were 66, 74.4, and 74.4 Gy, respectively. Overall, 49 (32%) patients had T1a, 38 (25%) had T1b, and 66 (43%) had T2 disease. The median treatment duration was 46 days. The median follow-up duration was 5.1 years. The 10-year overall and cause-specific survival rates were 72% and 97%, respectively. The 10-year local control rates were 94% for T1a, 88% for T1b, and 81% for T2 disease. Local control rates in patients with ACI were slightly better than those in patients without ACI with T1a and T1b diseases; however, the difference was not significant. The 10-year laryngeal preservation rate was 96%. Six patients experienced grade 3 mucositis, and four patients had grade 3 dermatitis. Hyperfractionated radiotherapy was effective for T1 disease with ACI, but insufficient for T2 disease with ACI. Our treatment strategy resulted in excellent laryngeal preservation.
喉声门 T1-T2 鳞状细胞癌的超分割放疗以前会厌受累为目标
约20%的早期声门鳞状细胞癌(EGSCC)累及前会厌。通过重点关注超分割放疗(62次分割,每次74.4 Gy),评估了前会厌受累(ACI)EGSCC的治疗效果和预后因素。本研究共纳入153例T1-T2 EGSCC患者。T1a、T1b和T2的中位总剂量分别为66、74.4和74.4 Gy。总体而言,49 名(32%)患者患有 T1a,38 名(25%)患者患有 T1b,66 名(43%)患者患有 T2。中位治疗时间为 46 天。中位随访时间为 5.1 年。10年总生存率和病因特异性生存率分别为72%和97%。T1a、T1b和T2疾病的10年局部控制率分别为94%、88%和81%。ACI 患者的局部控制率略高于无 ACI 的 T1a 和 T1b 患者,但差异并不显著。10年喉保留率为96%。6名患者出现3级粘膜炎,4名患者出现3级皮炎。超分割放疗对伴有 ACI 的 T1 病变有效,但对伴有 ACI 的 T2 病变效果不佳。我们的治疗策略很好地保留了喉部。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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