Intensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerability.

Autor: Held T; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. thomas.held@med.uni-heidelberg.de.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany. thomas.held@med.uni-heidelberg.de.; National Center for Tumor diseases (NCT), Heidelberg, Germany. thomas.held@med.uni-heidelberg.de., Franke H; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany., Lang K; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany., Eichkorn T; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany., Regnery S; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany., Weusthof K; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany., Bauer L; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany., Plath K; Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany., Dyckhoff G; Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany., Plinkert PK; Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany., Harrabi SB; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.; Heidelberg Ion Beam Therapy Center (HIT), Heidelberg, Germany.; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany., Herfarth K; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.; Heidelberg Ion Beam Therapy Center (HIT), Heidelberg, Germany.; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany., Debus J; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.; Heidelberg Ion Beam Therapy Center (HIT), Heidelberg, Germany.; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany., Adeberg S; Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; National Center for Tumor diseases (NCT), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.; Heidelberg Ion Beam Therapy Center (HIT), Heidelberg, Germany.; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
Jazyk: angličtina
Zdroj: Radiation oncology (London, England) [Radiat Oncol] 2022 Dec 05; Vol. 17 (1), pp. 199. Date of Electronic Publication: 2022 Dec 05.
DOI: 10.1186/s13014-022-02144-w
Abstrakt: Background: Due to the increasing expertise in transoral laser surgery and image-guided radiation therapy, treatment outcomes have recently improved in patients with early-stage glottic cancer. The objective of the current study was to evaluate intensity-modulated proton therapy (IMPT) as novel treatment option.
Methods: A total of 15 patients with T1-2N0 glottic squamous cell carcinoma, treated between 2017 and 2020, were evaluated. Toxicity was recorded according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.03.
Results: The majority were T1a/b tumors (66.7%) and no patient had lymph node or distant metastases. The median total dose was 70 Gy relative biological effectiveness (RBE) (range 66-70 Gy RBE). The one- and two-year OS and metastases-free survival were 100%. One patient developed local failure and received salvage laryngectomy. No higher-grade acute or late toxicity was reported. The mean number of CTCAE grade I and II overall toxicity events per patient was 4.1 (95%-[confidence interval] CI 3.1-5.3) and 1.0 (95%-CI 0.5-1.5).
Conclusion: High-precision proton therapy of T1-2N0 glottic cancer resulted in exceptional treatment tolerability with high rates of laryngeal function preservation and promising oncological outcome. IMPT has the potential to become a standard treatment option for patients with early-stage laryngeal cancer.
(© 2022. The Author(s).)
Databáze: MEDLINE
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