SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase i clinical trial

David Schwartz, Alan Sosa, Stephen G. Chun, Chiuxiong Ding, Xian Jin Xie, Lucien A. Nedzi, Robert D. Timmerman, Baran D. Sumer

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose To confirm safety and feasibility of hypofractionated SBRT for early-stage glottic laryngeal cancer. Methods Twenty consecutive patients with cTis-T2N0M0 carcinoma of glottic larynx were enrolled. Patients entered dose-fractionation cohorts of incrementally shorter bio-equivalent schedules starting with 50 Gy in 15 fractions (fx), followed by 45 Gy/10 fx and, finally, 42.5 Gy/5 fx. Maximum combined CTV-PTV expansion was limited to 5 mm. Patients were treated on a Model G5 Cyberknife (Accuray, Sunnyvale, CA). Results Median follow-up is 13.4 months (range: 5.6-24.6 months), with 12 patients followed for at least one year. Maximum acute toxicity consisted of grade 2 hoarseness and dysphagia. Maximum chronic toxicity was seen in one patient treated with 45 Gy/10 fx who continued to smoke >1 pack/day and ultimately required protective tracheostomy. At 1-year follow-up, estimated local disease free survival for the full cohort was 82%. Overall survival is 100% at last follow-up. Conclusions We were able to reduce equipotent total fractions of SBRT from 15 to 5 without exceeding protocol-defined acute/subacute toxicity limits. With limited follow-up, disease control appears comparable to standard treatment. We continue to enroll to the 42.5 Gy/5 fx cohort and follow patients for late toxicity.

Original languageEnglish (US)
Article numbere0172055
JournalPLoS One
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2017

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Tongue Neoplasms
Laryngeal Neoplasms
tongue
Toxicity
clinical trials
Clinical Trials
acute toxicity
Disease control
Fractionation
subacute toxicity
Smoke
Dose Fractionation
Hoarseness
chronic toxicity
larynx
Tracheostomy
smoke
Deglutition Disorders
Larynx
Tongue

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Schwartz, D., Sosa, A., Chun, S. G., Ding, C., Xie, X. J., Nedzi, L. A., ... Sumer, B. D. (2017). SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase i clinical trial. PLoS One, 12(3), [e0172055]. https://doi.org/10.1371/journal.pone.0172055

SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase i clinical trial. / Schwartz, David; Sosa, Alan; Chun, Stephen G.; Ding, Chiuxiong; Xie, Xian Jin; Nedzi, Lucien A.; Timmerman, Robert D.; Sumer, Baran D.

In: PLoS One, Vol. 12, No. 3, e0172055, 01.03.2017.

Research output: Contribution to journalArticle

Schwartz, D, Sosa, A, Chun, SG, Ding, C, Xie, XJ, Nedzi, LA, Timmerman, RD & Sumer, BD 2017, 'SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase i clinical trial', PLoS One, vol. 12, no. 3, e0172055. https://doi.org/10.1371/journal.pone.0172055
Schwartz, David ; Sosa, Alan ; Chun, Stephen G. ; Ding, Chiuxiong ; Xie, Xian Jin ; Nedzi, Lucien A. ; Timmerman, Robert D. ; Sumer, Baran D. / SBRT for early-stage glottic larynx cancer-Initial clinical outcomes from a phase i clinical trial. In: PLoS One. 2017 ; Vol. 12, No. 3.
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