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  • Title: Role of accelerated fractionated irradiation for supraglottic carcinoma: assessment of results.
    Author: Wang CC, Nakfoor BM, Spiro IJ, Martins P.
    Journal: Cancer J Sci Am; 1997; 3(2):88-91. PubMed ID: 9099458.
    Abstract:
    PURPOSE: We evaluated the results of locoregional control, patients' relapse-free survival, and voice preservation in patients with supraglottic carcinoma treated with accelerated radiation therapy. PATIENTS AND METHODS: The records of 164 patients undergoing accelerated fractionated radiation therapy for carcinoma of the supraglottis from 1981 to 1992 were reviewed and evaluated for locoregional control, disease-specific survival, and rates of voice preservation. All patients were treated with 1.6 Gy per fraction two fractions a day (BID) for 67.2 to 70.0 Gy in 6 weeks. The median follow-up was 56 months. Due to severe acute mucosal toxicity, all patients were given a short treatment break after 38.4 to 48.0 Gy. RESULTS: For T1, T2, T3, and T4 tumors, the 5-year actuarial local control rates were 96%, 86%, 76%, and 43%, respectively, and relapse-free survival rates were 78%, 82%, 64%, and 40%, respectively. With surgical salvage, the corresponding ultimate local control rates for the T1, T2, T3, and T4 tumors were 96%, 93%, 88%, and 51%, respectively. Regional control by T and N stage was non-significant. Voice preservation rates for the T1, T2, T3, and T4 tumors were 96%, 80%, 72%, and 43%, respectively, and for the entire group the rate was 79%. CONCLUSIONS: Accelerated fractionated radiation therapy resulted in excellent locoregional control, relapse-free survival, and voice preservation rates for patients with supraglottic carcinoma. The T stage and N stage were significant predictors of outcome. T4 tumors and node-positive neck disease portended a poor prognosis. These results as compared to our historical control and the published data in the literature with conventional once-daily radiation therapy (QD) suggested improved local control and patient survival after accelerated fractionated BID radiation therapy. For confirmation of these results, a prospective randomized trial is needed.
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