- Altered-fractionation radiotherapy (ART) is associated with fewer local failure events compared with chemoradiotherapy (CRT) in patients with early-stage (T1/T2) glottic carcinoma, according to a systematic review and meta-analysis.
- Significant benefit in T1 tumors may not extend to T2 disease.
Why this matters
- ART had previously shown relative benefits for a general population of patients with head and neck cancer; this study shows specific benefit for glottic cancer.
- ART was associated with fewer local failure events compared with CRT in an analysis of randomized controlled trials (RCTs; HR, 0.62; P=.0009) and retrospective studies (HR, 0.40; P=.0003).
- Hyperfractionation ART (HR, 0.65; P=.03) and hypofractionation ART (HR, 0.55; P=.02) were both associated with fewer local failure events compared with CRT.
- The benefit of ART was significant in studies with >50% patients with T1 disease (HR, 0.49; P<.00001 but not in studies with>50% patients with T2 disease (HR, 0.60; P=.15).
- 11 studies (4 RCTs and 7 two-group retrospective studies, 1762 total patients) were included in the meta-analysis.
- Funding: None.
- Inclusion of retrospective studies.
- Relatively small number of patients with T2 disease.