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

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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

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Tongue Neoplasms
Laryngeal Neoplasms
Radiosurgery
Radiotherapy
Research Ethics Committees
Feasibility Studies
Robotics
Larynx
Tongue
Spinal Cord
Thyroid Gland
Clinical Trials
Carcinoma

Keywords

  • CyberKnife
  • Laryngeal cancer
  • Phantom
  • SBRT

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

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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",
author = "Chuxiong Ding and Chun, {Stephen G.} and Sumer, {Baran D.} and Nedzi, {Lucien A.} and Abdulrahman, {Ramzi E.} and Yordy, {John S.} and Pam Lee and Brian Hrycushko and Solberg, {Timothy D.} and Chul Ahn and Timmerman, {Robert D.} and Schwartz, {David L.}",
year = "2017",
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TY - JOUR

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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KW - Laryngeal cancer

KW - Phantom

KW - SBRT

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