초기 성문암에서 방사선치료 : 소분할조사법에 의한 치료기간 단축의 영향

Abstract

Early stage glottic cancer can be cured by radiation therapy alone with voice preservation. I undertook to study the effect of hypofractionation treatment, which shortens treatment duration by increasing the fraction size in early stage laryngeal cancer, when radiation therapy was performed. Thirty patients with early stage (I, II) glottic cancer were treated with radiation therapy alone. The median age was 62, ranging from 43 to 73 years old. According to TNM stage, 21 patients were stage I, and nine were stage II. Mean total radiation doses were 63 Gy and 65 Gy with 2 Gy fraction in stage I and II in conventional treatment group, and 58 Gy and 62 Gy with 2.2 Gy fraction in stage I and II in hypofractionation group. Mean treatment durations were 46 days (39∼51) in conventional treatment group, and 39 days (35∼44) in hypofractionation group. The overall median follow-up period was 51.5 months with the range of 14 to 139 months. Local control rate was 96.6% (29/30) in all patients. Five year local relapse free survival rate (5YLRFS) was 83.3% in all patients, and 5YLRFS in stage I and II were 90% and 70% respectively. 5YLRFS in stage I and II of conventional treatment group were 100% and 71.4%, and 80% and 66.7% in stage I and II of hypofractionation group, having no statistical significance. Five (16%) patients, including one patient without local control, developed local failure after average 14 (5∼29) months, three of whom were salvaged by curative laryngectomy. There was no difference in the failure pattern between the conventional group and hypofractionation group. No patient suffered from above grade 3 acute and chronic complications. Total voice preservation was observed in 26 patients (86.6%). Although the present study was carried out with a small number of patients, there is no difference in local relapse free survival, failure pattern and complications between conventional treatment and hypofractionation groups which shortens the treatment time by increasing the fraction size from 2 Gy to 2.2 Gy. It is important to carry out radomized clinical study with a large number of patients.