Twice-a-day radiation therapy for supraglottic carcinoma |
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| Authors: | C C Wang H D Suit P H Blitzer |
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| Affiliation: | 1. Department of Radiation Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA;2. Department of Radiation Therapy, Harvard Medical School, Boston, MA, USA;1. Department of Radiotherapy, Policlinico Umberto I “Sapienza” University of Rome, Rome, Italy;2. Department of Sense Organs, Policlinico Umberto I “Sapienza” University of Rome, Italy;3. Department of Maxillofacial Surgery, Policlinico Umberto I “Sapienza” University of Rome, Italy;4. Department of Medical Oncology, Policlinico Umberto I “Sapienza” University of Rome, Italy;5. Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I “Sapienza” University of Rome, Italy;6. Departement of Odontostomatological Science, Policlinico Umberto I “Sapienza” University of Rome, Italy;1. Medical Physics Unit, A.O.U. Città della Salute e della Scienza, Corso Bramante 88/90, 10126 Turin, Italy;2. Department of Oncology, Radiation Oncology, University of Turin, Via Genova 3, 10126 Turin, Italy;3. Radiotherapy Unit, A.O.U. Città della Salute e della Scienza, Corso Bramante 88/90, 10126 Turin, Italy;1. International Atomic Energy Agency, Vienna, Austria;2. Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria;3. Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Vienna, Austria;4. Centre De Recherche Nucleaire D’alger, Alger Gare, Algeria;5. Instituto Nacional De Câncer, Rio De Janeiro, Brazil;6. Chinese Centre for Disease Control and Prevention, Beijing, China;7. National Radiation Protection Institute, Prague, Czech Republic;8. Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland;9. National Institute of Oncology and Radiobiology, Havana, Cuba;10. Radiation Standards Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre Trombay, Mumbai, India;11. SSDL, Bureau of Radiation and Medical Devices, Department of Medical Science, Nonthaburi, Thailand;12. CHU Charleroi, Hopital Andre Vesale, Montigny-le-Tilleul, Belgium;13. Helsinki University Hospital, Cancer Centre, Helsinki, Finland;14. University of Leeds, St James’s University Hospital, Leeds, United Kingdom;15. Imaging and Radiation Oncology Core Houston QA Centre, MD Anderson Cancer Centre, Houston, TX, United States;p. Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia;q. National University of Science and Technology, Bulawayo, Zimbabwe;r. Department of Medical Physics & Engineering, St James’s University Hospital, Leeds, United Kingdom;1. Celal Bayar University, Department of Otolaryngology-Head and Neck Surgery, Manisa, Turkey;2. Dokuz Eylül University, Institute of Oncology, Izmir, Turkey;3. Katip Celebi University, Department of Engineering Sciences, Izmir, Turkey;4. University of Pittsburgh, Division of Head Neck Surgery, Pittsburgh, PA, United States;1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA;2. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA;3. Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, USA;4. Department of Thoracic & Head and Neck Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA;5. Baylor College of Medicine, Houston, USA;6. Department of Clinical Oncology, University of Alexandria, Egypt;7. Athinoula A. Martinos Center for Biomedical Imaging/Massachusetts General Hospital/Massachusetts Institute of Technology, Charlestown, USA;8. Medical Physics Program, The University of Texas Graduate School of Biomedical Sciences, Houston, USA;9. The University of Texas Health Science Center at Houston Medical School, USA |
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| Abstract: | This is a report of a group of 106 patients with supraglottic carcinomas treated by the twice-a-day radiation therapy program at the Massachusetts General Hospital from October 1979 through April 1984. The program consisted of 1.6 Gy per fraction, 2 fractions a day, 5 days a week for a total of 64 Gy with 2 weeks rest after the twelfth b.i.d. day. The local control of this group of patients was compared to that of 79 patients treated by the conventional once-a-day program with a daily fraction of 1.8 Gy for a total of 65 Gy, at the same institution during the 4 years immediately prior to the b.i.d. program. The 3 year actuarial local control rate for the entire group following the twice-a-day program was 76% as compared to 50% after the once-a-day program. The difference was significant, p = 0.001. For the T1 and T2 lesions, the corresponding rates were 88 and 63%, respectively, with a p value of 0.029. The rates for T3 and T4 lesions were 66 and 33%, respectively, p = 0.0037. The study indicated that the twice-a-day radiation therapy program as outlined is effective in treatment of supraglottic carcinoma, and is more markedly effective in advanced lesions. Late radiation effects are minimal and salvage surgery is possible for radiation therapy failures. To date, no patient developed radiation myelitis following the b.i.d. program with the dose to the spinal cord limited to 38.4 Gy in 2.5 weeks. |
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