Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation

Abdallah S.R. Mohamed; Blaine D. Smith; Joshua B. Smith; Parag Sevak; Jessica S. Malek; Aasheesh Kanwar; Theodora Browne; G. Brandon Gunn; Adam S. Garden; Steven J. Frank; William H. Morrison; Jack Phan; Mark Zafereo; Heath Skinner; Stephen Y. Lai; Katherine A. Hutcheson; Jan S. Lewin; Amy E. Hessel; Apurva A. Thekdi; Randal S. Weber; Clifton D. Fuller; David I. Rosenthal

doi:10.1002/lary.27873

Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation

Abdallah S.R. Mohamed, Blaine D. Smith, Joshua B. Smith, Parag Sevak, Jessica S. Malek, Aasheesh Kanwar, Theodora Browne, G. Brandon Gunn, Adam S. Garden, Steven J. Frank, William H. Morrison, Jack Phan, Mark Zafereo, Heath Skinner, Stephen Y. Lai, Katherine A. Hutcheson, Jan S. Lewin, Amy E. Hessel, Apurva A. Thekdi, Randal S. WeberClifton D. Fuller, David I. Rosenthal

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

Objectives: We aim to report oncologic outcomes after conventional radiotherapy (ConRT) using opposed lateral beams and intensity-modulated radiation therapy (IMRT) for tumor (T)1 nodal (N)0 T1 N0 glottic squamous cell carcinoma. Study Design: Retrospective case-control study. Methods: We retrospectively reviewed demographic, disease, and treatment characteristics for patients treated at our institution during 2000 to 2013. Results: One hundred fifty-three patients (71%) were treated using ConRT and 62 (29%) using IMRT. The median follow-up for all patients was 68 months. There was no statistically significant difference in 5-year local control between patients with T1a versus T1b disease (94% vs. 89%, respectively, P = 0.5). Three-year locoregional control for patients treated with ConRT was 94% compared to 97% with IMRT (P = 0.4). Three-year overall survival (OS) for patients treated with ConRT was 92.5% compared with 100% with IMRT (P = 0.1). Twelve of 14 patients with local recurrence underwent salvage surgery with 5-year ultimate locoregional control of 98.5% and 97.1% in the ConRT and IMRT cohorts, respectively (P = 0.7). Multivariate analysis showed age < 60 years (P < 0.0001) and pretreatment Eastern Cooperative Oncology Group performance status <2 (P = 0.0022) to be independent correlates of improved OS. Postradiation cerebrovascular events were in four patients in the ConRT cohort (3%), whereas no patients in the IMRT cohort suffered any events. Conclusion: Because the oncologic outcomes for patients treated with IMRT were excellent and IMRT allows for carotid sparing, we have transitioned to IMRT as our standard for most patients with T1 glottic cancer. Level of Evidence: 3b Laryngoscope, 130:146–153, 2020.

Original language	English (US)
Pages (from-to)	146-153
Number of pages	8
Journal	Laryngoscope
Volume	130
Issue number	1
DOIs	https://doi.org/10.1002/lary.27873
State	Published - Jan 1 2020

Keywords

IMRT
T1 glottic squamous cell carcinoma
larynx cancer
oncologic outcomes
radiation therapy

ASJC Scopus subject areas

Otorhinolaryngology

MD Anderson CCSG core facilities

Clinical Trials Office

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10.1002/lary.27873

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Mohamed, A. S. R., Smith, B. D., Smith, J. B., Sevak, P., Malek, J. S., Kanwar, A., Browne, T., Gunn, G. B., Garden, A. S., Frank, S. J., Morrison, W. H., Phan, J., Zafereo, M., Skinner, H., Lai, S. Y., Hutcheson, K. A., Lewin, J. S., Hessel, A. E., Thekdi, A. A., ... Rosenthal, D. I. (2020). Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation. Laryngoscope, 130(1), 146-153. https://doi.org/10.1002/lary.27873

Mohamed, ASR, Smith, BD, Smith, JB, Sevak, P, Malek, JS, Kanwar, A, Browne, T, Gunn, GB , Garden, AS , Frank, SJ , Morrison, WH , Phan, J , Zafereo, M, Skinner, H, Lai, SY , Hutcheson, KA, Lewin, JS, Hessel, AE, Thekdi, AA, Weber, RS, Fuller, CD & Rosenthal, DI 2020, 'Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation', Laryngoscope, vol. 130, no. 1, pp. 146-153. https://doi.org/10.1002/lary.27873

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title = "Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation",

abstract = "Objectives: We aim to report oncologic outcomes after conventional radiotherapy (ConRT) using opposed lateral beams and intensity-modulated radiation therapy (IMRT) for tumor (T)1 nodal (N)0 T1 N0 glottic squamous cell carcinoma. Study Design: Retrospective case-control study. Methods: We retrospectively reviewed demographic, disease, and treatment characteristics for patients treated at our institution during 2000 to 2013. Results: One hundred fifty-three patients (71%) were treated using ConRT and 62 (29%) using IMRT. The median follow-up for all patients was 68 months. There was no statistically significant difference in 5-year local control between patients with T1a versus T1b disease (94% vs. 89%, respectively, P = 0.5). Three-year locoregional control for patients treated with ConRT was 94% compared to 97% with IMRT (P = 0.4). Three-year overall survival (OS) for patients treated with ConRT was 92.5% compared with 100% with IMRT (P = 0.1). Twelve of 14 patients with local recurrence underwent salvage surgery with 5-year ultimate locoregional control of 98.5% and 97.1% in the ConRT and IMRT cohorts, respectively (P = 0.7). Multivariate analysis showed age < 60 years (P < 0.0001) and pretreatment Eastern Cooperative Oncology Group performance status <2 (P = 0.0022) to be independent correlates of improved OS. Postradiation cerebrovascular events were in four patients in the ConRT cohort (3%), whereas no patients in the IMRT cohort suffered any events. Conclusion: Because the oncologic outcomes for patients treated with IMRT were excellent and IMRT allows for carotid sparing, we have transitioned to IMRT as our standard for most patients with T1 glottic cancer. Level of Evidence: 3b Laryngoscope, 130:146–153, 2020.",

keywords = "IMRT, T1 glottic squamous cell carcinoma, larynx cancer, oncologic outcomes, radiation therapy",

author = "Mohamed, {Abdallah S.R.} and Smith, {Blaine D.} and Smith, {Joshua B.} and Parag Sevak and Malek, {Jessica S.} and Aasheesh Kanwar and Theodora Browne and Gunn, {G. Brandon} and Garden, {Adam S.} and Frank, {Steven J.} and Morrison, {William H.} and Jack Phan and Mark Zafereo and Heath Skinner and Lai, {Stephen Y.} and Hutcheson, {Katherine A.} and Lewin, {Jan S.} and Hessel, {Amy E.} and Thekdi, {Apurva A.} and Weber, {Randal S.} and Fuller, {Clifton D.} and Rosenthal, {David I.}",

note = "Publisher Copyright: {\textcopyright} 2019 The American Laryngological, Rhinological and Otological Society, Inc.",

year = "2020",

month = jan,

day = "1",

doi = "10.1002/lary.27873",

language = "English (US)",

volume = "130",

pages = "146--153",

journal = "Laryngoscope",

issn = "0023-852X",

publisher = "John Wiley and Sons Inc.",

number = "1",

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TY - JOUR

T1 - Outcomes of carotid-sparing IMRT for T1 glottic cancer

T2 - Comparison with conventional radiation

AU - Mohamed, Abdallah S.R.

AU - Smith, Blaine D.

AU - Smith, Joshua B.

AU - Sevak, Parag

AU - Malek, Jessica S.

AU - Kanwar, Aasheesh

AU - Browne, Theodora

AU - Gunn, G. Brandon

AU - Garden, Adam S.

AU - Frank, Steven J.

AU - Morrison, William H.

AU - Phan, Jack

AU - Zafereo, Mark

AU - Skinner, Heath

AU - Lai, Stephen Y.

AU - Hutcheson, Katherine A.

AU - Lewin, Jan S.

AU - Hessel, Amy E.

AU - Thekdi, Apurva A.

AU - Weber, Randal S.

AU - Fuller, Clifton D.

AU - Rosenthal, David I.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Objectives: We aim to report oncologic outcomes after conventional radiotherapy (ConRT) using opposed lateral beams and intensity-modulated radiation therapy (IMRT) for tumor (T)1 nodal (N)0 T1 N0 glottic squamous cell carcinoma. Study Design: Retrospective case-control study. Methods: We retrospectively reviewed demographic, disease, and treatment characteristics for patients treated at our institution during 2000 to 2013. Results: One hundred fifty-three patients (71%) were treated using ConRT and 62 (29%) using IMRT. The median follow-up for all patients was 68 months. There was no statistically significant difference in 5-year local control between patients with T1a versus T1b disease (94% vs. 89%, respectively, P = 0.5). Three-year locoregional control for patients treated with ConRT was 94% compared to 97% with IMRT (P = 0.4). Three-year overall survival (OS) for patients treated with ConRT was 92.5% compared with 100% with IMRT (P = 0.1). Twelve of 14 patients with local recurrence underwent salvage surgery with 5-year ultimate locoregional control of 98.5% and 97.1% in the ConRT and IMRT cohorts, respectively (P = 0.7). Multivariate analysis showed age < 60 years (P < 0.0001) and pretreatment Eastern Cooperative Oncology Group performance status <2 (P = 0.0022) to be independent correlates of improved OS. Postradiation cerebrovascular events were in four patients in the ConRT cohort (3%), whereas no patients in the IMRT cohort suffered any events. Conclusion: Because the oncologic outcomes for patients treated with IMRT were excellent and IMRT allows for carotid sparing, we have transitioned to IMRT as our standard for most patients with T1 glottic cancer. Level of Evidence: 3b Laryngoscope, 130:146–153, 2020.

AB - Objectives: We aim to report oncologic outcomes after conventional radiotherapy (ConRT) using opposed lateral beams and intensity-modulated radiation therapy (IMRT) for tumor (T)1 nodal (N)0 T1 N0 glottic squamous cell carcinoma. Study Design: Retrospective case-control study. Methods: We retrospectively reviewed demographic, disease, and treatment characteristics for patients treated at our institution during 2000 to 2013. Results: One hundred fifty-three patients (71%) were treated using ConRT and 62 (29%) using IMRT. The median follow-up for all patients was 68 months. There was no statistically significant difference in 5-year local control between patients with T1a versus T1b disease (94% vs. 89%, respectively, P = 0.5). Three-year locoregional control for patients treated with ConRT was 94% compared to 97% with IMRT (P = 0.4). Three-year overall survival (OS) for patients treated with ConRT was 92.5% compared with 100% with IMRT (P = 0.1). Twelve of 14 patients with local recurrence underwent salvage surgery with 5-year ultimate locoregional control of 98.5% and 97.1% in the ConRT and IMRT cohorts, respectively (P = 0.7). Multivariate analysis showed age < 60 years (P < 0.0001) and pretreatment Eastern Cooperative Oncology Group performance status <2 (P = 0.0022) to be independent correlates of improved OS. Postradiation cerebrovascular events were in four patients in the ConRT cohort (3%), whereas no patients in the IMRT cohort suffered any events. Conclusion: Because the oncologic outcomes for patients treated with IMRT were excellent and IMRT allows for carotid sparing, we have transitioned to IMRT as our standard for most patients with T1 glottic cancer. Level of Evidence: 3b Laryngoscope, 130:146–153, 2020.

KW - IMRT

KW - T1 glottic squamous cell carcinoma

KW - larynx cancer

KW - oncologic outcomes

KW - radiation therapy

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Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation

Abstract

Keywords

ASJC Scopus subject areas

MD Anderson CCSG core facilities

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