Hypofractionated Radiotherapy for Stage I Squamous Cell Carcinoma Glottis: An Experience with 60Gy in 20 Fractions

Early-stage glottic cancer has a high cure rate with definitive radiotherapy. Historical reports show excellent local control. The present study evaluated the outcomes of early glottic cancer patients treated with a hypofractionated radiotherapy schedule of 60Gy in 20 fractions. This is a retrospective study of patients with stage I glottic cancer who received radical intent LINAC-based hypo-fractionated 3D conformal radiotherapy with a dose 60Gy in 20 fractions. The primary objective was to assess the locoregional control (LRC), and secondary objectives were to determine disease-free survival (DFS), overall survival (OS), and toxicity. The analysis included 105 patients from the age range of 35-88 years. About 69% of patients were over 60 years of age. The median overall treatment time (OTT) was 26 days (24 – 30 days). The mean follow-up was 74 months, ranging from 9 to 135 months. Seven patients had locoregional recurrence after an initial complete clinical response. Six had local, and one had a regional nodal recurrence. DFS at five years and ten years were 83% and 69%, and OS at five years and ten years were 87% and 80%, respectively. Most patients reported grade I skin reactions and tolerated the treatment well. We did not observe any late adverse events such as persistent laryngeal edema or radiation necrosis. The radiotherapy schedule of 60Gy in 20 fractions over four weeks offers comparable local disease control with reasonable long-term side effects in T1 glottic cancer.