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

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

来源：Medical Dosimetry, 2017, 42(2): 90-96.

DOI：10.1016/j.meddos.2017.01.004

• SBRT
• Laryngeal cancer
• Phantom
• CyberKnife

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-T2NOMO 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.

• 出版日期2017