Hyperfractionated-accelerated or conventionally fractionated radiotherapy for early glottic cancer

Purpose: To evaluate the effect of shortening overall treatment time by hyperfractionated-accelerated radiotherapy for T2N0M0 glottic carcinomas. Results for local control and survival were calculated and compared to those for T1N0M0 tumors treated with a once-a-day fractionated schedule. Methods and Materials: Between 1990 and 1998, 92 patients with T1N0M0 and 45 patients with T2N0M0 glottic cancers were treated with radical radiotherapy. The T1N0M0 tumors were treated with a once-a-day fractionated schedule lasting 6.5 weeks to a total dose of 62.4 Gy. The T2N0M0 tumors received a split-course hyperfractionated-accelerated treatment over a total of 4.5 weeks to a total dose of 64.6 Gy. Results: The 5-year local control was 85% for T1N0M0 and 88% for T2N0M0, whereas the 5-year locoregional control was 85% for both groups. The 5-year overall survival was 70% and 53% for T1N0M0 and T2N0M0, respectively. No significant statistical difference was found between the two groups for the parameters analyzed. The number of serious late complications was few and comparable for the two groups. Conclusions: Hyperfractionated-accelerated radiotherapy proved beneficial for T2N0M0 glottic cancer, giving local control rates comparable to those for T1N0M0 tumors. (C) 2002 Elsevier Science Inc.