Dose, fractionation and overall treatment time in radiation therapy — the effects on local control for cancer of the larynx

1994 ◽  
Vol 30 (2) ◽  
pp. 97-108 ◽  
Author(s):  
Wim L.J. van Putten ◽  
Maurice J.C. van der Sangen ◽  
Carel J.M. Hoekstra ◽  
Peter C. Levendag
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Treatment Time ◽  
Dose Fractionation ◽  
Overall Treatment Time

Dose, fractionation and overall treatment time in radiation therapy—The effects on local control for cancer of the larynx

1994 ◽  
Vol 19 (3) ◽  
pp. 188-189
Author(s):  
Wim L.J. van Putten ◽  
Maurice J.C. van der Sangen ◽  
Carel J.M. Hoekstra ◽  
Peter C. Levendag
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Treatment Time ◽  
Dose Fractionation ◽  
Overall Treatment Time

The Effect of Overall Treatment Time of Radiation Therapy on Local Control of T1-Stage Squamous Call Carcinoma of the Glottis

1996 ◽  
Vol 106 (12) ◽  
pp. 1545-1547 ◽  
Author(s):  
Kazushige Hayakawa ◽  
Norio Mitsuhashi ◽  
Tetsuo Akimoto ◽  
Katsuya Maebayashi ◽  
Hitoshi Ishikawa ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Treatment Time ◽  
Overall Treatment Time ◽  
T1 Stage

T1-T2N0 Squamous Cell Carcinoma of the Glottic Larynx Treated With Radiation Therapy

2001 ◽  
Vol 19 (20) ◽  
pp. 4029-4036 ◽  
Author(s):  
William M. Mendenhall ◽  
Robert J. Amdur ◽  
Christopher G. Morris ◽  
Russell W. Hinerman
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Treatment Time ◽  
Survival Rates ◽  
Glottic Carcinoma ◽  
Overall Treatment Time ◽  
Poorly Differentiated ◽  
Histologic Differentiation ◽  
Lost To Follow Up

PURPOSE: The end results after radiation therapy for T1-T2N0 glottic carcinoma vary considerably. We analyze patient-related and treatment-related parameters that may influence the likelihood of cure. PATIENTS AND METHODS: Five hundred nineteen patients were treated with radiation therapy and had follow-up for ≥ 2 years. Three patients who were disease-free were lost to follow-up at 7 months, 21 months, and 10.5 years. No other patients were lost to follow-up. RESULTS: Local control rates at 5 years after radiation therapy were as follows: T1A, 94%; T1B, 93%; T2A, 80%; and T2B, 72%. Multivariate analysis of local control revealed that the following parameters significantly influenced this end point: overall treatment time (P < .0001), T stage (P = .0003), and histologic differentiation (P = .013). Patients with poorly differentiated cancers fared less well than those with better differentiated lesions. Rates of local control with laryngeal preservation at 5 years were as follows: T1A and T1B, 95%; T2A, 82%; and T2B, 76%. Cause-specific survival rates at 5 years were as follows: T1A and T1B, 98%; T2A, 95%; and T2B, 90%. One patient with a T1N0 cancer and three patients with T2N0 lesions experienced severe late radiation complications. CONCLUSION: Radiation therapy cures a high percentage of patients with T1-T2N0 glottic carcinomas and has a low rate of severe complications. The major treatment-related parameter that influences the likelihood of cure is overall treatment time.

Is Radiation Therapy a Preferred Alternative to Surgery for Squamous Cell Carcinoma of the Base of Tongue?

2000 ◽  
Vol 18 (1) ◽  
pp. 35-35 ◽  
Author(s):  
William M. Mendenhall ◽  
Scott P. Stringer ◽  
Robert J. Amdur ◽  
Russell W. Hinerman ◽  
Giselle J. Moore-Higgs ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
Cell Carcinoma ◽  
Local Control ◽  
Treatment Time ◽  
Overall Treatment Time ◽  
Regional Control ◽  
Base Of Tongue ◽  
Local Regional Control

PURPOSE: To evaluate irradiation alone for treatment of base-of-tongue cancer. PATIENTS AND METHODS: Two hundred seventeen patients with squamous cell carcinoma of the base of tongue were treated with radiation alone and had follow-up for ≥ 2 years. RESULTS: Local control rates at 5 years were as follows: T1, 96%; T2, 91%; T3, 81%; and T4, 38%. Multivariate analysis revealed that T stage (P = .0001) and overall treatment time (P = .0006) significantly influenced local control. The 5-year rates of local-regional control were as follows: I, 100%; II, 100%; III, 83%; IVA, 64%; and IVB, 65%. Multivariate analysis revealed that the following parameters significantly affect the probability of this end point: T stage (P = .0001), overall treatment time (P = .0001), overall stage (P = .0131), and addition of a neck dissection (P = .0021). The rates of absolute and cause-specific survival at 5 years were as follows: I, 50% and 100%; II, 81% and 100%; III, 65% and 76%; IVA, 42% and 56%; and IVB, 44% and 52%. Severe radiation complications developed in eight patients (4%). CONCLUSION: The likelihood of cure after external-beam irradiation was related to stage, overall treatment time, and addition of a planned neck dissection. The local-regional control rates and survival rates after radiation therapy were comparable to those after surgery, and the morbidity associated with irradiation was less.

Radiation therapy for T1,2 glottic carcinoma: impact of overall treatment time on local control

1996 ◽  
Vol 40 (3) ◽  
pp. 225-232 ◽  
Author(s):  
Yasumasa Nishimura ◽  
Yasushi Nagata ◽  
Kaoru Okajima ◽  
Michihide Mitsumori ◽  
Masahiro Hiraoka ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Treatment Time ◽  
Glottic Carcinoma ◽  
Overall Treatment Time

Altered Fractionation Schedules in Radiotherapy of Head and Neck Cancer. A Review

1992 ◽  
Vol 78 (5) ◽  
pp. 311-325 ◽  
Author(s):  
Carlo Fallai ◽  
Patrizia Olmi
Keyword(s):  
Total Dose ◽  
Head And Neck ◽  
Local Control ◽  
Randomized Trials ◽  
Treatment Time ◽  
Dose Intensity ◽  
Field Size ◽  
Overall Treatment Time ◽  
Altered Fractionation ◽  
Improvement In Survival

The authors review the main contributions of international literature to show the current status in clinical trials on unconventional fractionations of the dose in radiotherapy of head and neck cancers. Several clinical (but only a few randomized) trials have been conducted over the last 15 years using hyperfractionated (HF), accelerated (AF) or mixed (HF-AF) schedules. HF schedules have obtained promising results in terms of local control in comparison with conventional fractionation (CF) of the dose. Improvement in survival was also obtained by the random trials of Pinto and Sanchiz, whereas in EORTC trial no. 22791, the improvement in survival rate was only marginal. A significant increase in local control and, less frequently, in survival has been claimed in several studies using HF-AF. Such data still need to be confirmed by a random study, since EORTC trial 22811 showed superimposable results in comparison with CF. Selection of the most suitable cases for altered fractionation schemes is also being studied in ongoing trials of the EORTC (22851) and RTOG (90-03). As regards acute reactions during and after altered fractionation, they are more severe than after CF. Only pure HF with a dose intensity approximately comparable to CF seems to produce similar acute reactions. Several factors have been found to influence the severity of acute mucosal reactions: interfraction interval, overall treatment time, total dose, and field size. As regards late damage, genuine HF schemes seem to cause roughly equivalent late damage in comparison to CF, whereas high-dose intensity schedules have a higher rate of complications. Interfraction interval, overall treatment time, total dose, fraction size and field size can influence the risk of late sequelae. Before altered fractionations can be considered standard therapy, more data are needed, which should be provided by multicentric randomized trials, some of which are already in progress.

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