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Title: Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules

Abstract

Purpose: This population-based study describes the treatment of early glottic cancer in Ontario, Canada and assesses whether treatment variations were associated with treatment effectiveness. Methods and Materials: We studied 491 T1N0 and 213 T2N0 patients. Data abstracted from charts included age, sex, stage, treatment details, disease control, and survival. Results: The total dose ranged from 50 to 70 Gy, and the daily dose ranged from 1.9 to 2.8 Gy. In 90%, treatment duration was between 25 and 50 days. Field sizes, field reductions, beam arrangement, and beam energy varied. Late treatment breaks occurred in 13.6% of T1N0 and 27.1% of T2N0 cases. Local control was comparable to other reports for T1N0 (82% at 5 years), but was only 63.2% in T2N0. Variables associated with local failure in T1N0 were age less than 49 years (relative risk [RR], 3.21; 95% confidence interval [CI], 1.49-6.90) and >3 treatment interruption days (RR, 2.43; 95% CI, 1.00-5.91). In T2N0, these were field reduction (RR, 2.33; 95% CI, 1.23-4.42) and late treatment breaks (RR, 2.19; 95% CI, 1.09-4.41). Conclusion: Some aspects of treatment for early glottic cancer were associated with worse local control. Problems with protracted treatment are of particular concern, underscoring the need formore » randomized studies to intensify radiotherapy.« less

Authors:
 [1];  [2];  [3];  [3];  [3];  [4];  [2];  [5];  [5];  [5];  [5];  [5];  [5];  [5];  [5]
  1. Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, ON (Canada). E-mail: patti.groome@krcc.on.ca
  2. Department of Radiation Oncology, University Health Network, University of Toronto, Toronto, ON (Canada)
  3. Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, ON (Canada)
  4. Department of Otolaryngology, University Health Network, University of Toronto, Toronto, ON (Canada)
  5. Regional Cancer Centres, Cancer Care Ontario, Toronto, ON (Canada)
Publication Date:
OSTI Identifier:
20793375
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2005.10.010; PII: S0360-3016(05)02814-2; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BEAMS; DIGESTIVE SYSTEM; FAILURES; HAZARDS; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Groome, Patti A., O'Sullivan, Brian, Mackillop, William J., Jackson, Lynda D., Schulze, Karleen M.Math., Irish, Jonathan C., Warde, Padraig R., Schneider, Ken M., Mackenzie, Robert G., Hodson, D. Ian, Hammond, J. Alex, Gulavita, Sunil P.P., Eapen, Libni J., Dixon, Peter F. M.B., and Bissett, Randy J. Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.1.
Groome, Patti A., O'Sullivan, Brian, Mackillop, William J., Jackson, Lynda D., Schulze, Karleen M.Math., Irish, Jonathan C., Warde, Padraig R., Schneider, Ken M., Mackenzie, Robert G., Hodson, D. Ian, Hammond, J. Alex, Gulavita, Sunil P.P., Eapen, Libni J., Dixon, Peter F. M.B., & Bissett, Randy J. Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules. United States. doi:10.1016/J.IJROBP.2005.1.
Groome, Patti A., O'Sullivan, Brian, Mackillop, William J., Jackson, Lynda D., Schulze, Karleen M.Math., Irish, Jonathan C., Warde, Padraig R., Schneider, Ken M., Mackenzie, Robert G., Hodson, D. Ian, Hammond, J. Alex, Gulavita, Sunil P.P., Eapen, Libni J., Dixon, Peter F. M.B., and Bissett, Randy J. Wed . "Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules". United States. doi:10.1016/J.IJROBP.2005.1.
@article{osti_20793375,
title = {Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules},
author = {Groome, Patti A. and O'Sullivan, Brian and Mackillop, William J. and Jackson, Lynda D. and Schulze, Karleen M.Math. and Irish, Jonathan C. and Warde, Padraig R. and Schneider, Ken M. and Mackenzie, Robert G. and Hodson, D. Ian and Hammond, J. Alex and Gulavita, Sunil P.P. and Eapen, Libni J. and Dixon, Peter F. M.B. and Bissett, Randy J.},
abstractNote = {Purpose: This population-based study describes the treatment of early glottic cancer in Ontario, Canada and assesses whether treatment variations were associated with treatment effectiveness. Methods and Materials: We studied 491 T1N0 and 213 T2N0 patients. Data abstracted from charts included age, sex, stage, treatment details, disease control, and survival. Results: The total dose ranged from 50 to 70 Gy, and the daily dose ranged from 1.9 to 2.8 Gy. In 90%, treatment duration was between 25 and 50 days. Field sizes, field reductions, beam arrangement, and beam energy varied. Late treatment breaks occurred in 13.6% of T1N0 and 27.1% of T2N0 cases. Local control was comparable to other reports for T1N0 (82% at 5 years), but was only 63.2% in T2N0. Variables associated with local failure in T1N0 were age less than 49 years (relative risk [RR], 3.21; 95% confidence interval [CI], 1.49-6.90) and >3 treatment interruption days (RR, 2.43; 95% CI, 1.00-5.91). In T2N0, these were field reduction (RR, 2.33; 95% CI, 1.23-4.42) and late treatment breaks (RR, 2.19; 95% CI, 1.09-4.41). Conclusion: Some aspects of treatment for early glottic cancer were associated with worse local control. Problems with protracted treatment are of particular concern, underscoring the need for randomized studies to intensify radiotherapy.},
doi = {10.1016/J.IJROBP.2005.1},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 64,
place = {United States},
year = {Wed Mar 15 00:00:00 EST 2006},
month = {Wed Mar 15 00:00:00 EST 2006}
}