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Title: Hypofractionation vs. conventional radiotherapy fractionation in the conservative treatment of T1 glottic cancer: a prospective cohort study
Authors: Salas-Salas, B. G.
Domínguez-Nuez, D. J.
Cabrera, R.
Ferrera-Alayón, L.
Lloret Sáez-Bravo, Marta 
Lara Jiménez, Pedro Carlos 
UNESCO Clasification: 320101 Oncología
320111 Radiología
Keywords: Conservative Treatment
Larynx Cancer
Local Control
Overall Survival
Radiotherapy Scheme, et al
Issue Date: 2019
Journal: Clinical and Translational Oncology 
Abstract: Background: Definitive radiotherapy is an effective single-modality in T1 glottic cancer. Hypofractionated schemes could offer excellent results in a shorter treatment period. We aimed to evaluate the clinical outcomes and toxicity comparing conventional vs. hypofractionated radiotherapy treatment in T1N0M0-glottic cancer. Patients and Methods: Between Jan-1st, 2005 and August-1st, 2017, in a prospective cohort study, with 10-year follow-up, 138 patients were treated with conventional schedule 2 Gy/day, total dose 70 Gy/7 weeks (N = 71) or hypofractionated schedule 2, 2–2, 25 Gy/day, total dose 63, 8–63 Gy/5, 5 weeks (N = 67). Endpoints were clinical-response rate, local relapse-free survival (LRFS), laryngectomy-free survival (LFS), toxicity rates, relapse-free survival (RFS), metastasis-free survival (MFS), second tumour-free survival (2TFS), and overall survival (OS). Results: All patients showed a complete clinical response. No differences were found for LRFS (p = 0.869), LFS (p = 0.975), RFS (p = 0.767), MFS (p = 0.601), 2TFS (p = 0.293), or OS (p = 0.685). Acute toxicity for skin and mucosae was similar (p = 0.550 and p = 0.698). Acute laryngeal toxicity was higher in the hypofractionation group (p = 0.004), due to an increase in slight moderate grade. No differences in late laryngeal edema were found (p = 0.989). Conclusion: Radiotherapy offers high rate survival, local control, and larynx preservation after 5–10-year follow-up. A hypofractionation could be preferable, since it offers the same results as conventional with fewer treatment sessions.
ISSN: 1699-048X
DOI: 10.1007/s12094-019-02118-7
Source: Clinical and Translational Oncology [ISSN 1699-048X], v. 22, p. 151–157
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