389 Locoregional control and disease specific survival after accelerated hyperfractionated radiotherapy in the treatment of supraglottic carcinoma

Abstract

Materials and Methods The records of 165 patients undergoing BID radiation for carcinoma of the supraglottis from 1981–1992 were reviewed. Patients received 66 to 72 Gy in 1.6 Gy bid fractions and received a planned 7 to 14 day break. Median follow-up was 56 months. Fiveyear actuarial local control, regional control and disease-specific survival rates are reported. Results For T1, T2, T3, and T4 tumors, local control was: 95%, 86%, 77% and 42%, respectively (P = 0.002), and disease-specific survival was: 79%, 88%, 78%, and 40%, respectively (P = 0.0004). For N0, N1, N2−3 disease, local control was: 86%, 73%, and 54%, respectively (P = 0.005), and disease-specific survival was: 86%, 53%, and 54%, respectively (P = 0.0001). Regional control by T and N stage was non-significant. With surgical salvage, T1, T2, T3, and T4 ultimate local control was: 95%, 92%, 88%, and 51%, respectively (P = 0.001). The laryngeal preservation rate for the entire group was 83% and for T1, T2, T3, and T4 tumors was: 96%, 87%, 78%, and 56%, respectively. Total treatment time greater than 43 days resulted in a decreased local control: 87% versus 70% (P = 0.002), and decreased disease-specific survival: 84% versus 69% (P = 0.01). Conclusions Accelerated hyperfractionated radiotherapy resulted in excellent locoregional control, disease-specific survival, and laryngeal preservation rates for T1−3 and node negative patients. T stage, N stage and total treatment time were predictors of outcome. T4 tumors or node positive neck disease, even N1, portended a poor prognosis, and therefore these patients should be entered into protocols that include adjuvant therapy.