Top Line: Is accelerated fractionation superior to standard fractionation for early glottic cancer?
The Study: A single-center randomized trial found that accelerated fractionation had better local control for early stage glottic cancer. JCOG0701 was a multicenter, randomized, phase 3 trial designed to determine if accelerated fractionation (AF) resulted in non-inferior PFS compared to standard fractionation (SF) in patients with early stage squamous cell carcinoma of the glottic larynx. The original 3 year results showed similar PFS (79.9% v 81.7%) and local failure (15.9% v 10.3%) between SF and AF, however the non-inferiority of AF could not be confirmed statistically. Here we have long-term results of JCOG0701. 370 patients with cT1N0 (75%) or cT2N0 (25%) disease and no impaired vocal cord mobility were randomized to definitive treatment with either standard fractionation (66 Gy in 30 fractions for T1, 70 Gy in 35 fractions for T2) or accelerated fractionation (60 Gy in 25 fractions for T1, 64.8 Gy in 27 fractions for T2). At 5 and 7 years, the rates of PFS were similar between SF and AF (5 years: 76.2% v 78.2%, 7 years: 72.7% v 74.8%). Overall survival was also similar. However, the cumulative incidence of local progression at 7 years was lower with AF (10.9% v 18.4%). The difference in local progression between AF and SF was most apparent for T2 disease (4.4% v 20.6%). Late grade 2+ toxicity was lower in the AF arm (7.6% v 14.3%).
TBL: Long-term results of JCOG0701 found that accelerated fractionation for early stage SCC of the glottic larynx has similar survival outcomes, better local control, and less late toxicity compared to standard fractionation. | Kodaira, Int J Radiat Oncol Biol Phys 2023
The Study: A single-center randomized trial found that accelerated fractionation had better local control for early stage glottic cancer. JCOG0701 was a multicenter, randomized, phase 3 trial designed to determine if accelerated fractionation (AF) resulted in non-inferior PFS compared to standard fractionation (SF) in patients with early stage squamous cell carcinoma of the glottic larynx. The original 3 year results showed similar PFS (79.9% v 81.7%) and local failure (15.9% v 10.3%) between SF and AF, however the non-inferiority of AF could not be confirmed statistically. Here we have long-term results of JCOG0701. 370 patients with cT1N0 (75%) or cT2N0 (25%) disease and no impaired vocal cord mobility were randomized to definitive treatment with either standard fractionation (66 Gy in 30 fractions for T1, 70 Gy in 35 fractions for T2) or accelerated fractionation (60 Gy in 25 fractions for T1, 64.8 Gy in 27 fractions for T2). At 5 and 7 years, the rates of PFS were similar between SF and AF (5 years: 76.2% v 78.2%, 7 years: 72.7% v 74.8%). Overall survival was also similar. However, the cumulative incidence of local progression at 7 years was lower with AF (10.9% v 18.4%). The difference in local progression between AF and SF was most apparent for T2 disease (4.4% v 20.6%). Late grade 2+ toxicity was lower in the AF arm (7.6% v 14.3%).
TBL: Long-term results of JCOG0701 found that accelerated fractionation for early stage SCC of the glottic larynx has similar survival outcomes, better local control, and less late toxicity compared to standard fractionation. | Kodaira, Int J Radiat Oncol Biol Phys 2023