• Radiation Oncology Journal
• /
• v.34 no.1
• /
• pp.18-25
• /
• 2016

Purpose: Radiotherapy of the neck is known to cause carotid artery stenosis. We compared the carotid artery dose received between volumetric modulated arc therapy (VMAT) and conventional fixed-field intensity-modulated radiotherapy (IMRT) plans in patients with early glottic cancer. Materials and Methods: Twenty-one early glottic cancer patients who previously underwent definitive radiotherapy were selected for this study. For each patient, double arc VMAT, 8-field IMRT, 3-dimensional conformal radiotherapy (3DCRT), and lateral parallel-opposed photon field radiotherapy (LPRT) plans were created. The 3DCRT plan was generated using lateral parallel-opposed photon fields plus an anterior photon field. VMAT and IMRT treatment plan optimization was performed under standardized conditions to obtain adequate target volume coverage and spare the carotid artery. Dose-volume specifications for the VMAT, IMRT, 3DCRT, and LPRT plans were calculated with radiotherapy planning system. Monitor units (MUs) and delivery time were measured to evaluate treatment efficiency. Results: Target volume coverage and homogeneity results were comparable between VMAT and IMRT; however, VMAT was superior to IMRT for carotid artery dose sparing. The mean dose to the carotid arteries in double arc VMAT was reduced by 6.8% compared to fixed-field IMRT (p < 0.001). The MUs for VMAT and IMRT were not significantly different (p = 0.089). VMAT allowed an approximately two-fold reduction in treatment delivery time in comparison to IMRT (3 to 5 minutes vs. 5 to 10 minutes). Conclusion: VMAT resulted in a lower carotid artery dose compared to conventional fixed-field IMRT, and maintained good target coverage in patients with early glottic cancer.

• Medical Lasers
• /
• v.10 no.2
• /
• pp.111-114
• /
• 2021

A 38-year-old man visited the hospital for a voice change that began two months previously. There were no other accompanying symptoms; the patient had a history of 20 years of smoking. Carbon dioxide (CO₂) laser cordectomy was performed on the left side of the vocal cord, and the biopsy results showed squamous cell carcinoma. Radiation therapy was not performed, and CO₂ laser cordectomy was performed again because of a recurrence of left vocal cord mass three years after a progress observation.

• Radiation Oncology Journal
• /
• v.16 no.3
• /
• pp.245-250
• /
• 1998

Purpose : This study was to evaluate survival, failure patterns, and prognostic factors of stage I squamous cell carcinoma of the glottic larynx after curative radiation therapy. Materials and Methods : A retrospective analysis was done for 57 patients with glottic cancer who were treated with curative radiation therapy from June 1985 to November 1992. There were 55 male and two female patients. Patients' age ranged from 17 to 71 years(median 39 years). Radiation therapy was delivered five times a week, 2 Gy daily, total 66 Gy using 6 MV X-ray. Results : Complete response(CR) was noted in 51 out of 57 patients (89.5%) and persistent disease (PER) in six out of 57 patients(10.5%). The disease-free survival rates at 3 and 5 years were 72.9% and 63.8%, respectively. Seven failures were observed among 51 CR patients during follow-up. Salvage total laryngectomy for six recurred patients and partial laryngectomy for one recurred patient were done with successful results, i.e., all of them were actually salvaged. Among six PER patients, salvage total laryngectomy for two patients and partial laryngectomy for two patients were done and two patients refused operation. Following salvage surgery for the four PER patients, three were salvaged and one failed locoregionally. Among the 13 failures 10(76.9%) were salvaged with surgery. The ultimate local control rate at 5 years was 92.3% and overall 47 out of 57 (82.5%) patients were able to preserve their larynx. The 5-year disease-free survival rates were 85.5% for posterior lesions, and 61.6% for anterior lesions(P<0.05). Cord mobility, involvement of anterior commissure, field size, and T stage did not impact on disease-free survival. Conclusion : Considering the high percentage of voice preservation with initial radiotherapy, radiotherapy should be the first choice in the treatment of stage 1 glottic carcinoma.

• Radiation Oncology Journal
• /
• v.8 no.1
• /
• pp.51-57
• /
• 1990

Retrospective analyses were done of 48 patients with early glottic cancer, 31 with T1NOMO and 17 with T2NOMO, who received radiation therapy from March 1979 to August 1984 at Seoul National University Hospital with the prescribed full dosage. The median follow-up period was 67 months (range: 34 months$\~$126 months), and the percent follow-up for longer than five years was $85.4\%$ The five-year actuarial overall and recurrence-free survival rates of the whole patient group were $83.2\%\;and\;69.4\%$, respectively. The five-year actuarial overall and recurrence-free survival rates of the T1 group were $87.1\%\;and\;76.0\%$, and those of the T2 group were $76.5\%\;and\;58.2\%$, respectively. Possible causes of the failures to radiation therapy, the dose-response relationship, association with the second malignant tumors, and some recommendations for better treatment outcome are analyzed and discussed.

• Korean Journal of Head & Neck Oncology
• /
• v.4 no.1
• /
• pp.41-51
• /
• 1988

To evaluate the result of radiation therapy for twenty years experience, a total of 115 cases of pathologically proven glottic carcinoma had been analyzed according tot survival respectively. All the patients had been treated with radiation therapy in curative intent using Co-60 teletherapy machine. The results are as follows: 1) Accoridng to sex, 5YSR & 10YSR were 58.7% and 50.4% in male patients, and 80.0% & 72.0% in female. 2) According to T staging, 5YSR & 10YSR were 83.4% & 83.4% in T1, 69.2% & 60.0% in T2, 34.3% & 21.8% in T3, 32.0% & 0% in T4. 3) According to N staging, 5YSR & 10YSR were 63.8% & 59.2% in node-negative groups, and 30.7% & 15.4% in node-positive groups. 4) According to the histologic grade, 5YSR & 10YSR were 66.8% & 57.6% in G1, 61.3% 54.3% in G2, and 35.0% 35.0% in G3. 5) According to AJC staging, 5YSR & 10YSR were 83.4%% 83.4% in stage I, 72.0% & 62.7% in stage II, 36.8% & 28.3% in stage III, and 14.3% & 7.1% in stage IV. 6) In summary, 5YSR & 10YSR wre 60.4% & 52.8% in glottic carcinoma.

• Radiation Oncology Journal
• /
• v.8 no.2
• /
• pp.199-205
• /
• 1990

During a ten-year period from 1978 through 1987, 44 patients with T2NOMO glottic cancer were treated with radical radiation therapy at the Yonsei University Medical Center. Forty-two patients had a minimum follow-up of 3 years, and $81\%$ had at least five years of follow-up. Patients were staged according to the AJCC system. Forty-two patients have been analyzed in detail with respect to two variables: the status of vocal cord mobility and the degree of local extension of the disease. Five-year local recurrence free survival rates were as follows: All 42 patients, $53.3\%$ patients with normal vocal cord mobility (n =18), $69.1\%$ versus patients with impaired vocal cord mobility (n=24), $43.4\%$(p<0.05); patients with subglottic extension (n=15), $36.7$ versus patients without subglottic extension (n=29), $61.9\%$ (p<0.05). The most favorable Prognostic group included the patients with normal mobility without subglottic extension (n=14), $83.1\%$. On the basis of this analysis, we confirmed the presence of heterogeneity in T2NOMO glottic cancer This study indicates that further randomized controlled trials are warranted to evaluate.

• Proceedings of the KSLP Conference
• /
• 2017.04a
• /
• pp.100-100
• /
• 2017

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1993.05a
• /
• pp.105-105
• /
• 1993

Laryngeal cancer is the commonest of all head and neck malignancies and, in Korea, constitutes approximately 2.3% of all malignancies among males. Survival rate is rather higher than any other head and neck malignancies. Treatment results of 121 laryngeal cancer patients were analyzed. 1. Glottic region 44%, supraglottic 41%, subglottic 8%, transglottic 7%. 2. Rate of cervical metastasis according to T stage was 19% in T2 stage, 47% in T3 stage, 69% in T4 stage. 3. Overall 3-year NED survival rate was 65% and showed stage I 93%, stage II 76%, stage III 63%, stage IV 53%. 4. Glottic cancer showed much better prognosis(3-year NED 82%) than supraglottic cancer(3-year NED 58 %). 5. According to treatment modality, complication rates in surgery with postoperative radiation was higher than in surgery along and disproportionally higher in salvage surgery after failed curative radiation.

• Radiation Oncology Journal
• /
• v.19 no.4
• /
• pp.301-305
• /
• 2001

Purpose : This study was peformed for the evaluation of the feasibility and toxicity of hypofractionated radiation therapy for early glottic cancer Methods and Materials : From February 1999 to February 2000, 20 patients with Histologically confirmed Stage I, II glottic cancer were enrolled into this study. There were 18 males and 2 females, the median age of the patients was 59 years. The distribution of stage distribution was as fellows; T1aN0-16 patients, T1bN0-1 patient, T2N0-3 patients. Eighteen patients underwent laryngomicroscopic biopsy only, and two patients underwent laser cordectomy. All patients received radical radiation therapy (2.5 Gy per fraction, 24 fractions, total 60 Gy). Median duration of treatment was 36 days (range $31\~45\;days$). Results : Radiation therapy were well tolerated. Most common acute reactions were odynophagia and hoarseness, and these reactions resolved after radiation therapy. There were one case of RTOG grade 3 odynophagia $(5\%)$, six cases of grade 3 hoarseness $(30\%)$. Response of radiation therapy was evaluated one month after completion of treatment. All patients revealed complete response. During follow up, total three cases of treatment failure were detected. two cases were local recurrence in 10 and 13 months of radiation therapy and one case was local recurrence and distant metastasis in 2 months of radiation therapy. Conclusion : This hypofractionated radiation therapy schedule was feasible and effective for control of early glottic cancer But longer follow up time would be required to assess the long-term disease control and the late complication by shortening radiation therapy duration.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.226-232
• /
• 2000

Purpose :This study was performed to find out the prognostic factors affecting local control in early glottic cancer treated with radiation therapy alone. Materials and Methods :We analysed 37 patients of histologically confirmed early glottic cancer treated at Chonnam National University Hospital between July Im and December 1995, retrospectively. Age of patients ranged from 30 to 73 years (median; 59 years). Thirty-five (95$\%$) patients were male. Histological type was all squamous cell carcinoma. According to the staging system of 1997 American Joint Committee on Cancer, 37 patients were restaged as follows: Tla; U (73$\%$), Tlb; 3 (8$\%$), 72: 7 (19$\%$). Radiation therapy was done using 6 MV X-ray of linear accelerator The range of total radiation dose delivered to the glottic lesion was between 5,040 cGy and 7,020 cGy (median; 6,600 cGy). Median follow-up period was U months. local control rates were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of control rates between comparable groups. Multivariate analysis using Cox proportional hazard model was done to find out prognostic factors affecting local control. Results:5 year survival rate of 37 patients was 89$\%$. Local control rate of 37 patients was 74$\%$ in 5 years. We included age, 7-stage, anterior commissure involvement, fraction size, total radiation dose, treatment time of radiotherapy as potential prognostic factors in univariate and multivariate analysis. As a result, treatment time had statistical significance in local control rate in both univariate (p=0.026) and multivariate (p=0.017) analysis. Complication was not recorded except one patient with hypothyroidism. Conclusion :This study revealed that overall treatment time of radiation was a significant factor affecting local control rate.