Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer

Chuxiong Ding; Stephen G. Chun; Baran D. Sumer; Lucien A. Nedzi; Ramzi E. Abdulrahman; John S. Yordy; Pam Lee; Brian Hrycushko; Timothy D. Solberg; Chul Ahn; Robert D. Timmerman; David L. Schwartz

doi:10.1016/j.meddos.2017.01.004

Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer

Chuxiong Ding, Stephen G. Chun, Baran D. Sumer, Lucien A. Nedzi, Ramzi E. Abdulrahman, John S. Yordy, Pam Lee, Brian Hrycushko, Timothy D. Solberg, Chul Ahn, Robert D. Timmerman, David L. Schwartz

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT. Our results demonstrate that SBRT plans improved sparing of the contralateral arytenoid (mean 20.0 Gy reduction, p < 0.001), ipsilateral carotid D_max (mean 20.6 Gy reduction, p < 0.001), contralateral carotid D_max (mean 28.1 Gy reduction, p < 0.001), and thyroid D_mean (mean 15.0 Gy reduction, p < 0.001) relative to carotid-sparing IMRT. SBRT also modestly improved dose sparing to the contralateral arytenoid (mean 4.8 Gy reduction, p = 0.13) and spinal cord D_max (mean 4.9 Gy reduction, p = 0.015) relative to selective hemilaryngeal IMRT plans. This “phantom-to-clinic” feasibility study confirmed that hypofractionated SBRT treatment for early-stage laryngeal cancer can potentially spare dose to adjacent normal tissues relative to current IMRT standards. Clinical efficacy and toxicity correlates continue to be collected through an ongoing prospective trial.

Original language	English (US)
Pages (from-to)	90-96
Number of pages	7
Journal	Medical Dosimetry
Volume	42
Issue number	2
DOIs	https://doi.org/10.1016/j.meddos.2017.01.004
State	Published - Feb 2 2017

Keywords

CyberKnife
Laryngeal cancer
Phantom
SBRT

ASJC Scopus subject areas

Radiological and Ultrasound Technology
Oncology
Radiology Nuclear Medicine and imaging

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10.1016/j.meddos.2017.01.004

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Ding, C., Chun, S. G., Sumer, B. D., Nedzi, L. A., Abdulrahman, R. E., Yordy, J. S., Lee, P., Hrycushko, B., Solberg, T. D., Ahn, C., Timmerman, R. D., & Schwartz, D. L. (2017). Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer. Medical Dosimetry, 42(2), 90-96. https://doi.org/10.1016/j.meddos.2017.01.004

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title = "Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer",

abstract = "The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT. Our results demonstrate that SBRT plans improved sparing of the contralateral arytenoid (mean 20.0 Gy reduction, p < 0.001), ipsilateral carotid Dmax (mean 20.6 Gy reduction, p < 0.001), contralateral carotid Dmax (mean 28.1 Gy reduction, p < 0.001), and thyroid Dmean (mean 15.0 Gy reduction, p < 0.001) relative to carotid-sparing IMRT. SBRT also modestly improved dose sparing to the contralateral arytenoid (mean 4.8 Gy reduction, p = 0.13) and spinal cord Dmax (mean 4.9 Gy reduction, p = 0.015) relative to selective hemilaryngeal IMRT plans. This “phantom-to-clinic” feasibility study confirmed that hypofractionated SBRT treatment for early-stage laryngeal cancer can potentially spare dose to adjacent normal tissues relative to current IMRT standards. Clinical efficacy and toxicity correlates continue to be collected through an ongoing prospective trial.",

keywords = "CyberKnife, Laryngeal cancer, Phantom, SBRT",

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T1 - Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer

AU - Ding, Chuxiong

AU - Chun, Stephen G.

AU - Sumer, Baran D.

AU - Nedzi, Lucien A.

AU - Abdulrahman, Ramzi E.

AU - Yordy, John S.

AU - Lee, Pam

AU - Hrycushko, Brian

AU - Solberg, Timothy D.

AU - Ahn, Chul

AU - Timmerman, Robert D.

AU - Schwartz, David L.

PY - 2017/2/2

Y1 - 2017/2/2

N2 - The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT. Our results demonstrate that SBRT plans improved sparing of the contralateral arytenoid (mean 20.0 Gy reduction, p < 0.001), ipsilateral carotid Dmax (mean 20.6 Gy reduction, p < 0.001), contralateral carotid Dmax (mean 28.1 Gy reduction, p < 0.001), and thyroid Dmean (mean 15.0 Gy reduction, p < 0.001) relative to carotid-sparing IMRT. SBRT also modestly improved dose sparing to the contralateral arytenoid (mean 4.8 Gy reduction, p = 0.13) and spinal cord Dmax (mean 4.9 Gy reduction, p = 0.015) relative to selective hemilaryngeal IMRT plans. This “phantom-to-clinic” feasibility study confirmed that hypofractionated SBRT treatment for early-stage laryngeal cancer can potentially spare dose to adjacent normal tissues relative to current IMRT standards. Clinical efficacy and toxicity correlates continue to be collected through an ongoing prospective trial.

AB - The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT. Our results demonstrate that SBRT plans improved sparing of the contralateral arytenoid (mean 20.0 Gy reduction, p < 0.001), ipsilateral carotid Dmax (mean 20.6 Gy reduction, p < 0.001), contralateral carotid Dmax (mean 28.1 Gy reduction, p < 0.001), and thyroid Dmean (mean 15.0 Gy reduction, p < 0.001) relative to carotid-sparing IMRT. SBRT also modestly improved dose sparing to the contralateral arytenoid (mean 4.8 Gy reduction, p = 0.13) and spinal cord Dmax (mean 4.9 Gy reduction, p = 0.015) relative to selective hemilaryngeal IMRT plans. This “phantom-to-clinic” feasibility study confirmed that hypofractionated SBRT treatment for early-stage laryngeal cancer can potentially spare dose to adjacent normal tissues relative to current IMRT standards. Clinical efficacy and toxicity correlates continue to be collected through an ongoing prospective trial.

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Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer

Abstract

Keywords

ASJC Scopus subject areas

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