SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase I clinical trial

David L Schwartz; Alan Sosa; Stephen G Chun; Chiuxiong Ding; Xian-Jin Xie; Lucien A Nedzi; Robert D Timmerman; Baran D Sumer

doi:10.1371/journal.pone.0172055

Back

SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase I clinical trial

Journal article

Open access

Peer reviewed

SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase I clinical trial

David L Schwartz, Alan Sosa, Stephen G Chun, Chiuxiong Ding, Xian-Jin Xie, Lucien A Nedzi, Robert D Timmerman and Baran D Sumer

PloS one, Vol.12(3), e0172055

2017

DOI: 10.1371/journal.pone.0172055

PMCID: PMC5333979

PMID: 28253270

Files and links (1)

url

https://doi.org/10.1371/journal.pone.0172055View

Published (Version of record) Open Access

Abstract

To confirm safety and feasibility of hypofractionated SBRT for early-stage glottic laryngeal cancer. Twenty consecutive patients with cTis-T2N0M0 carcinoma of glottic larynx were enrolled. Patients entered dose-fractionation cohorts of incrementally shorter bio-equivalent schedules starting with 50 Gy in 15 fractions (fx), followed by 45 Gy/10 fx and, finally, 42.5 Gy/5 fx. Maximum combined CTV-PTV expansion was limited to 5 mm. Patients were treated on a Model G5 Cyberknife (Accuray, Sunnyvale, CA). Median follow-up is 13.4 months (range: 5.6-24.6 months), with 12 patients followed for at least one year. Maximum acute toxicity consisted of grade 2 hoarseness and dysphagia. Maximum chronic toxicity was seen in one patient treated with 45 Gy/10 fx who continued to smoke >1 pack/day and ultimately required protective tracheostomy. At 1-year follow-up, estimated local disease free survival for the full cohort was 82%. Overall survival is 100% at last follow-up. We were able to reduce equipotent total fractions of SBRT from 15 to 5 without exceeding protocol-defined acute/subacute toxicity limits. With limited follow-up, disease control appears comparable to standard treatment. We continue to enroll to the 42.5 Gy/5 fx cohort and follow patients for late toxicity. ClinicalTrials.gov NCT01984502.

Laryngeal Neoplasms - radiotherapy

Humans

Middle Aged

Glottis - radiation effects

Radiosurgery

Dose Fractionation

Female

Male

Treatment Outcome

Molybdoferredoxin

Neoplasm Staging

Laryngeal Neoplasms - pathology

Details

Title: Subtitle: SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase I clinical trial
Creators: David L Schwartz - Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Alan Sosa - Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Stephen G Chun - Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Chiuxiong Ding - Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Xian-Jin Xie - Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Lucien A Nedzi - Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Robert D Timmerman - Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Baran D Sumer - Department of Otolaryngology, Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
Resource Type: Journal article
Publication Details: PloS one, Vol.12(3), e0172055
DOI: 10.1371/journal.pone.0172055
PMID: 28253270
PMCID: PMC5333979
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: United States
Grant note: DOI: 10.13039/100004917, name: CPRIT, award: RP150386; DOI: 10.13039/100004917, name: CPRIT, award: RP150485
Language: English
Date published: 2017
Academic Unit: Preventive and Community Dentistry; Biostatistics; Dental Research
Record Identifier: 9983917675202771

Metrics

32 Record Views

26 Times Cited - Web of Science