Cureus · 2025
A Single-Center Retrospective Comparative Study of Conventional and Accelerated Fractionated Radiotherapy for Early-Stage Laryngeal Cancer.
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Kaguchi Juno, Nakata Kensei, Suzuki Fumiyuki, Someya Masanori, Ikeda Hikaru
Аннотация
INTRODUCTION: Radiotherapy is widely used in the treatment of early-stage laryngeal cancer (stage I and II). We analyzed the efficacy of conventional and accelerated fractionated radiotherapy (52.5 Gy in 16 fractions) for early-stage laryngeal cancer retrospectively.
MATERIALS AND METHODS: We compared the outcomes of 25 patients treated with conventional fractionation (CF group: 66-70 Gy in 33-35 fractions) and 20 patients treated with accelerated fractionation (AF group: 52.5 Gy in 16 fractions) radiotherapy from 2011 to 2024 at our institution.
RESULTS: Local control rate was 87.8% at five years in the CF group and 95% at five years in the AF group. Acute adverse events were significantly higher in the CF group, with 72% Grade 2 or higher dermatitis compared to 20% in the AF group (p < 0.01). No serious late adverse events of Grade 2 or higher were observed in either group. The COVID-19 pandemic increased the use of AF from 34.3% before COVID-19 to 66.7% afterwards, suggesting that AF is a reasonable option as a curative strategy; AF has a shorter overall treatment time (median 22 days), better local control rates, and fewer adverse events.
CONCLUSION: Accelerated fractionated radiotherapy of 52.5 Gy in 16 fractions for early-stage laryngeal cancer is a safe and effective option for patients with poor performance status, older age, severe comorbidities, or difficulty with long-term hospital stays, offering a shorter overall treatment time without affecting the cure rate.
MATERIALS AND METHODS: We compared the outcomes of 25 patients treated with conventional fractionation (CF group: 66-70 Gy in 33-35 fractions) and 20 patients treated with accelerated fractionation (AF group: 52.5 Gy in 16 fractions) radiotherapy from 2011 to 2024 at our institution.
RESULTS: Local control rate was 87.8% at five years in the CF group and 95% at five years in the AF group. Acute adverse events were significantly higher in the CF group, with 72% Grade 2 or higher dermatitis compared to 20% in the AF group (p < 0.01). No serious late adverse events of Grade 2 or higher were observed in either group. The COVID-19 pandemic increased the use of AF from 34.3% before COVID-19 to 66.7% afterwards, suggesting that AF is a reasonable option as a curative strategy; AF has a shorter overall treatment time (median 22 days), better local control rates, and fewer adverse events.
CONCLUSION: Accelerated fractionated radiotherapy of 52.5 Gy in 16 fractions for early-stage laryngeal cancer is a safe and effective option for patients with poor performance status, older age, severe comorbidities, or difficulty with long-term hospital stays, offering a shorter overall treatment time without affecting the cure rate.