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Article

Patterns of Care and Outcomes of Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy for Early Stage Glottic Cancer: A National Cancer Database Analysis

1
Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL 60637, USA
2
Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, USA
*
Author to whom correspondence should be addressed.
Cancers 2019, 11(12), 1996; https://doi.org/10.3390/cancers11121996
Received: 13 October 2019 / Revised: 28 November 2019 / Accepted: 10 December 2019 / Published: 12 December 2019
(This article belongs to the Special Issue Emerging Concepts in Treatment of Laryngeal Cancer)
Early stage glottic cancer has traditionally been treated with 3D conformal radiotherapy (3DCRT). However, intensity-modulated radiotherapy (IMRT) has been recently adopted as an alternative to decrease toxicity. Here, we compared the usage and outcomes of IMRT and 3DCRT for patients with early stage squamous cell carcinoma (SCC) of the glottic larynx. Using the National Cancer Database, we identified patients with Stage I–II SCC of the glottis who received 55–75 Gy using IMRT (n = 1623) or 3DCRT (n = 2696). Median follow up was 42 months with a 5-year overall survival (OS) of 72%. Using a nominal logistic regression, race, ethnicity, year of diagnosis and fraction size were associated with the receipt of IMRT (p < 0.05). Using Kaplan–Meier methods and Cox proportional hazards models as well as a propensity matched cohort, there was no difference in OS for patients who received IMRT versus 3DCRT (hazard ratio (HR), 1.08; 95% confidence interval (95% CI), 0.93–1.26; p = 0.302). However, there was a survival benefit for patients receiving slight hypofractionation as compared to conventional fractionation (HR, 0.78; 95% CI, 0.69–0.92; p = 0.003). IMRT was associated with similar survival as 3DCRT, supporting the implementation of this potentially less toxic modality without compromising survival. View Full-Text
Keywords: radiotherapy; laryngeal neoplasms; carcinoma; squamous cell radiotherapy; laryngeal neoplasms; carcinoma; squamous cell
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MDPI and ACS Style

Korpics, M.C.; Turchan, W.T.; Rooney, M.K.; Koshy, M.; Spiotto, M.T. Patterns of Care and Outcomes of Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy for Early Stage Glottic Cancer: A National Cancer Database Analysis. Cancers 2019, 11, 1996. https://doi.org/10.3390/cancers11121996

AMA Style

Korpics MC, Turchan WT, Rooney MK, Koshy M, Spiotto MT. Patterns of Care and Outcomes of Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy for Early Stage Glottic Cancer: A National Cancer Database Analysis. Cancers. 2019; 11(12):1996. https://doi.org/10.3390/cancers11121996

Chicago/Turabian Style

Korpics, Mark C., W. T. Turchan, Michael K. Rooney, Matthew Koshy, and Michael T. Spiotto. 2019. "Patterns of Care and Outcomes of Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy for Early Stage Glottic Cancer: A National Cancer Database Analysis" Cancers 11, no. 12: 1996. https://doi.org/10.3390/cancers11121996

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