Single vocal cord irradiation: a competitive treatment strategy in early glottic cancer

Peter C Levendag, David N Teguh, Fatma Keskin-Cambay, Abrahim Al-Mamgani, Peter van Rooij, Eleftheria Astreinidou, Stefan L S Kwa, Ben Heijmen, Dominique A Monserez, Sarah O S Osman

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

INTRODUCTION: The treatment of choice for early glottic cancer is still being debated; ultimately it relies on the functional outcome. This paper reports on a novel sparing 4D conformal technique for single vocal cord irradiation (SVCI).

MATERIAL AND METHODS: The records of 164 T1a patients with SCC of the vocal cord, irradiated in the Erasmus MC between 2000 and 2008, were analyzed for local control and overall survival. The quality of life was determined by EORTC H&N35 questionnaires. Also the VHI (voice handicap index), and the TSH (thyroid stimulating hormone) blood levels, were established. On-line image guided SVCI, using cone beam CT or stereotactic radiation therapy (SRT) techniques, were developed.

RESULTS: A LC rate at five-years of 93% and a VHI of 12.7 (0-63) was determined. It appeared feasible to irradiate one vocal cord within 1-2mm accuracy. This way sparing of the contralateral (CL) vocal cord and CL normal tissues, could be achieved.

CONCLUSIONS: Given the accuracy (1-2mm) and small volume disease (CTV limited to one vocal cord), for the use of stereotactic RT techniques SVCI with large fraction sizes is currently being investigated in clinic. It is argued that hypofractionated SVCI can be a competitive alternative to laser surgery.

Original languageEnglish
Pages (from-to)415-9
Number of pages5
JournalRadiotherapy and Oncology
Volume101
Issue number3
DOIs
Publication statusPublished - Dec 2011

Fingerprint

Tongue Neoplasms
Vocal Cords
Therapeutics
Stereotaxic Techniques
Cone-Beam Computed Tomography
Laser Therapy
Thyrotropin
Radiotherapy
Quality of Life
Survival

Bibliographical note

Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Keywords

  • Carcinoma, Squamous Cell
  • Cone-Beam Computed Tomography
  • Glottis
  • Humans
  • Laryngeal Neoplasms
  • Radiosurgery
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Image-Guided
  • Radiotherapy, Intensity-Modulated
  • Vocal Cords

Cite this

Levendag, Peter C ; Teguh, David N ; Keskin-Cambay, Fatma ; Al-Mamgani, Abrahim ; van Rooij, Peter ; Astreinidou, Eleftheria ; Kwa, Stefan L S ; Heijmen, Ben ; Monserez, Dominique A ; Osman, Sarah O S. / Single vocal cord irradiation : a competitive treatment strategy in early glottic cancer. In: Radiotherapy and Oncology. 2011 ; Vol. 101, No. 3. pp. 415-9.
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title = "Single vocal cord irradiation: a competitive treatment strategy in early glottic cancer",
abstract = "INTRODUCTION: The treatment of choice for early glottic cancer is still being debated; ultimately it relies on the functional outcome. This paper reports on a novel sparing 4D conformal technique for single vocal cord irradiation (SVCI).MATERIAL AND METHODS: The records of 164 T1a patients with SCC of the vocal cord, irradiated in the Erasmus MC between 2000 and 2008, were analyzed for local control and overall survival. The quality of life was determined by EORTC H&N35 questionnaires. Also the VHI (voice handicap index), and the TSH (thyroid stimulating hormone) blood levels, were established. On-line image guided SVCI, using cone beam CT or stereotactic radiation therapy (SRT) techniques, were developed.RESULTS: A LC rate at five-years of 93{\%} and a VHI of 12.7 (0-63) was determined. It appeared feasible to irradiate one vocal cord within 1-2mm accuracy. This way sparing of the contralateral (CL) vocal cord and CL normal tissues, could be achieved.CONCLUSIONS: Given the accuracy (1-2mm) and small volume disease (CTV limited to one vocal cord), for the use of stereotactic RT techniques SVCI with large fraction sizes is currently being investigated in clinic. It is argued that hypofractionated SVCI can be a competitive alternative to laser surgery.",
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Levendag, PC, Teguh, DN, Keskin-Cambay, F, Al-Mamgani, A, van Rooij, P, Astreinidou, E, Kwa, SLS, Heijmen, B, Monserez, DA & Osman, SOS 2011, 'Single vocal cord irradiation: a competitive treatment strategy in early glottic cancer', Radiotherapy and Oncology, vol. 101, no. 3, pp. 415-9. https://doi.org/10.1016/j.radonc.2011.05.026, https://doi.org/10.1016/j.radonc.2011.05.026.

Single vocal cord irradiation : a competitive treatment strategy in early glottic cancer. / Levendag, Peter C; Teguh, David N; Keskin-Cambay, Fatma; Al-Mamgani, Abrahim; van Rooij, Peter; Astreinidou, Eleftheria; Kwa, Stefan L S; Heijmen, Ben; Monserez, Dominique A; Osman, Sarah O S.

In: Radiotherapy and Oncology, Vol. 101, No. 3, 12.2011, p. 415-9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Single vocal cord irradiation

T2 - a competitive treatment strategy in early glottic cancer

AU - Levendag, Peter C

AU - Teguh, David N

AU - Keskin-Cambay, Fatma

AU - Al-Mamgani, Abrahim

AU - van Rooij, Peter

AU - Astreinidou, Eleftheria

AU - Kwa, Stefan L S

AU - Heijmen, Ben

AU - Monserez, Dominique A

AU - Osman, Sarah O S

N1 - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

PY - 2011/12

Y1 - 2011/12

N2 - INTRODUCTION: The treatment of choice for early glottic cancer is still being debated; ultimately it relies on the functional outcome. This paper reports on a novel sparing 4D conformal technique for single vocal cord irradiation (SVCI).MATERIAL AND METHODS: The records of 164 T1a patients with SCC of the vocal cord, irradiated in the Erasmus MC between 2000 and 2008, were analyzed for local control and overall survival. The quality of life was determined by EORTC H&N35 questionnaires. Also the VHI (voice handicap index), and the TSH (thyroid stimulating hormone) blood levels, were established. On-line image guided SVCI, using cone beam CT or stereotactic radiation therapy (SRT) techniques, were developed.RESULTS: A LC rate at five-years of 93% and a VHI of 12.7 (0-63) was determined. It appeared feasible to irradiate one vocal cord within 1-2mm accuracy. This way sparing of the contralateral (CL) vocal cord and CL normal tissues, could be achieved.CONCLUSIONS: Given the accuracy (1-2mm) and small volume disease (CTV limited to one vocal cord), for the use of stereotactic RT techniques SVCI with large fraction sizes is currently being investigated in clinic. It is argued that hypofractionated SVCI can be a competitive alternative to laser surgery.

AB - INTRODUCTION: The treatment of choice for early glottic cancer is still being debated; ultimately it relies on the functional outcome. This paper reports on a novel sparing 4D conformal technique for single vocal cord irradiation (SVCI).MATERIAL AND METHODS: The records of 164 T1a patients with SCC of the vocal cord, irradiated in the Erasmus MC between 2000 and 2008, were analyzed for local control and overall survival. The quality of life was determined by EORTC H&N35 questionnaires. Also the VHI (voice handicap index), and the TSH (thyroid stimulating hormone) blood levels, were established. On-line image guided SVCI, using cone beam CT or stereotactic radiation therapy (SRT) techniques, were developed.RESULTS: A LC rate at five-years of 93% and a VHI of 12.7 (0-63) was determined. It appeared feasible to irradiate one vocal cord within 1-2mm accuracy. This way sparing of the contralateral (CL) vocal cord and CL normal tissues, could be achieved.CONCLUSIONS: Given the accuracy (1-2mm) and small volume disease (CTV limited to one vocal cord), for the use of stereotactic RT techniques SVCI with large fraction sizes is currently being investigated in clinic. It is argued that hypofractionated SVCI can be a competitive alternative to laser surgery.

KW - Carcinoma, Squamous Cell

KW - Cone-Beam Computed Tomography

KW - Glottis

KW - Humans

KW - Laryngeal Neoplasms

KW - Radiosurgery

KW - Radiotherapy Planning, Computer-Assisted

KW - Radiotherapy, Image-Guided

KW - Radiotherapy, Intensity-Modulated

KW - Vocal Cords

U2 - 10.1016/j.radonc.2011.05.026

DO - 10.1016/j.radonc.2011.05.026

M3 - Article

C2 - 21663989

VL - 101

SP - 415

EP - 419

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

IS - 3

ER -