Single vocal cord irradiation for early-stage glottic cancer: Excellent local control and favorable toxicity profile

Lisa Tans*, Abrahim Al-Mamgani, Stefan L.S. Kwa, Jos B.W. Elbers, Fatma Keskin-Cambay, Aniel Sewnaik, Maarten Dorr, Remi Nout, Wilma Heemsbergen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objective: To validate the earlier reported promising oncologic outcomes and favorable toxicity profile following single vocal cord irradiation (SVCI) in an expanded cohort of patients with early-stage glottic cancer treated at our institute with longer follow-up time. Materials and methods: Between February 2011 and January 2020, 111 consecutive patients with early-stage glottic cancer were treated with SVCI to the whole involved vocal cord (58.08 Gy, given in 16 fractions of 3.63 Gy). Setup verification was done using cone-beam CT, prior to each fraction. The endpoints were local control (LC), overall survival (OS), grade ≥ 3 toxicity and voice quality assessment using voice-handicap index (VHI) questionnaires. Results: Median follow-up was 41 months (range; 8–84). Two patients developed in-field local failure (LF). The 3- and 5-year LC rates were 99.1% and 97.1%, respectively. As both patients with LF were successfully salvaged with total laryngectomy, the 5-year ultimate LC-rates was 99%. The 5-years OS was 80.6%. All patients finished treatment without any interruption. No patients developed acute grade ≥ 3 toxicity. Late grade 3 toxicity was reported in 7 patients (6.5%) out of 108 patients evaluable for late toxicity; 2 because of severe hoarseness and 5 because of laryngeal radionecrosis (4.5%). The 5-years laryngectomy-free survival was 98.1%. The VHI-scores improved over time, only 22% of patients had VHI > 30 at 3-years post-radiotherapy, compared to 38% at baseline. Conclusions: Local control rate and laryngectomy-free survival of SVCI are excellent with favorable toxicity profile and good VHI-score. These results validate our early results.

Original languageEnglish
Article number105782
JournalOral Oncology
Volume127
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Funding Information: Between February 2011 and January 2020, 111 consecutive patients with previously untreated ESGC, who were not suitable for laser surgery, were treated with SVCI in our institute. All patients had a histologically proven squamous cell carcinoma (T1a) or severe dysplasia limited to one vocal cord. Patients with minimal invasion to the ipsilateral supraglottic region (very limited T2) were also eligible. Permission for retrospective anonymized data collection for the current study was obtained after protocol review by the Medical Ethical Committee of the Erasmus Medical Center (reference number MEC-2020-0234).

Publisher Copyright: © 2022 The Authors

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