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 journalArticle

2 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 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.

Original languageEnglish (US)
Pages (from-to)90-96
Number of pages7
JournalMedical Dosimetry
Volume42
Issue number2
DOIs
StatePublished - 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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