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

Abstract 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 no...

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Main Authors: Thomas Held, Henrik Franke, Kristin Lang, Tanja Eichkorn, Sebastian Regnery, Katharina Weusthof, Lukas Bauer, Karim Plath, Gerhard Dyckhoff, Peter K. Plinkert, Semi B. Harrabi, Klaus Herfarth, Jürgen Debus, Sebastian Adeberg
Format: Article
Language:English
Published: BMC 2022-12-01
Series:Radiation Oncology
Subjects:
Online Access:https://doi.org/10.1186/s13014-022-02144-w
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author Thomas Held
Henrik Franke
Kristin Lang
Tanja Eichkorn
Sebastian Regnery
Katharina Weusthof
Lukas Bauer
Karim Plath
Gerhard Dyckhoff
Peter K. Plinkert
Semi B. Harrabi
Klaus Herfarth
Jürgen Debus
Sebastian Adeberg
author_facet Thomas Held
Henrik Franke
Kristin Lang
Tanja Eichkorn
Sebastian Regnery
Katharina Weusthof
Lukas Bauer
Karim Plath
Gerhard Dyckhoff
Peter K. Plinkert
Semi B. Harrabi
Klaus Herfarth
Jürgen Debus
Sebastian Adeberg
author_sort Thomas Held
collection DOAJ
description Abstract 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.
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spelling doaj.art-b4bfb39d0e314a7baa74b18936529ee12022-12-22T04:18:48ZengBMCRadiation Oncology1748-717X2022-12-011711810.1186/s13014-022-02144-wIntensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerabilityThomas Held0Henrik Franke1Kristin Lang2Tanja Eichkorn3Sebastian Regnery4Katharina Weusthof5Lukas Bauer6Karim Plath7Gerhard Dyckhoff8Peter K. Plinkert9Semi B. Harrabi10Klaus Herfarth11Jürgen Debus12Sebastian Adeberg13Department of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Otorhinolaryngology, Head and Neck Surgery, University of HeidelbergDepartment of Otorhinolaryngology, Head and Neck Surgery, University of HeidelbergDepartment of Otorhinolaryngology, Head and Neck Surgery, University of HeidelbergDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalAbstract 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.https://doi.org/10.1186/s13014-022-02144-wHead and neck cancerLaryngeal cancerSquamous cell carcinomaProton therapyGlottic cancerRadiotherapy
spellingShingle Thomas Held
Henrik Franke
Kristin Lang
Tanja Eichkorn
Sebastian Regnery
Katharina Weusthof
Lukas Bauer
Karim Plath
Gerhard Dyckhoff
Peter K. Plinkert
Semi B. Harrabi
Klaus Herfarth
Jürgen Debus
Sebastian Adeberg
Intensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerability
Radiation Oncology
Head and neck cancer
Laryngeal cancer
Squamous cell carcinoma
Proton therapy
Glottic cancer
Radiotherapy
title Intensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerability
title_full Intensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerability
title_fullStr Intensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerability
title_full_unstemmed Intensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerability
title_short Intensity modulated proton therapy for early-stage glottic cancer: high-precision approach to laryngeal function preservation with exceptional treatment tolerability
title_sort intensity modulated proton therapy for early stage glottic cancer high precision approach to laryngeal function preservation with exceptional treatment tolerability
topic Head and neck cancer
Laryngeal cancer
Squamous cell carcinoma
Proton therapy
Glottic cancer
Radiotherapy
url https://doi.org/10.1186/s13014-022-02144-w
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