{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:37:10Z","timestamp":1790609830470,"version":"4.1.0"},"reference-count":27,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T00:00:00Z","timestamp":1576108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000861","name":"Burroughs Wellcome Fund","doi-asserted-by":"publisher","award":["1010964"],"award-info":[{"award-number":["1010964"]}],"id":[{"id":"10.13039\/100000861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DE027445-01"],"award-info":[{"award-number":["R01DE027445-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Early stage glottic cancer has traditionally been treated with 3D conformal radiotherapy (3DCRT). However, intensity-modulated radiotherapy (IMRT) has been recently adopted as an alternative to decrease toxicity. Here, we compared the usage and outcomes of IMRT and 3DCRT for patients with early stage squamous cell carcinoma (SCC) of the glottic larynx. Using the National Cancer Database, we identified patients with Stage I\u2013II SCC of the glottis who received 55\u201375 Gy using IMRT (n = 1623) or 3DCRT (n = 2696). Median follow up was 42 months with a 5-year overall survival (OS) of 72%. Using a nominal logistic regression, race, ethnicity, year of diagnosis and fraction size were associated with the receipt of IMRT (p &lt; 0.05). Using Kaplan\u2013Meier methods and Cox proportional hazards models as well as a propensity matched cohort, there was no difference in OS for patients who received IMRT versus 3DCRT (hazard ratio (HR), 1.08; 95% confidence interval (95% CI), 0.93\u20131.26; p = 0.302). However, there was a survival benefit for patients receiving slight hypofractionation as compared to conventional fractionation (HR, 0.78; 95% CI, 0.69\u20130.92; p = 0.003). IMRT was associated with similar survival as 3DCRT, supporting the implementation of this potentially less toxic modality without compromising survival.<\/jats:p>","DOI":"10.3390\/cancers11121996","type":"journal-article","created":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T11:06:41Z","timestamp":1576148801000},"page":"1996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Patterns of Care and Outcomes of Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy for Early Stage Glottic Cancer: A National Cancer Database Analysis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8449-2986","authenticated-orcid":false,"given":"Mark C.","family":"Korpics","sequence":"first","affiliation":[{"name":"Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL 60637, USA"},{"name":"Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Tyler","family":"Turchan","sequence":"additional","affiliation":[{"name":"Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL 60637, USA"},{"name":"Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K.","family":"Rooney","sequence":"additional","affiliation":[{"name":"Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL 60637, USA"},{"name":"Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Koshy","sequence":"additional","affiliation":[{"name":"Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL 60637, USA"},{"name":"Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4484-462X","authenticated-orcid":false,"given":"Michael T.","family":"Spiotto","sequence":"additional","affiliation":[{"name":"Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL 60637, USA"},{"name":"Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.mlg.0000236095.97947.26","article-title":"Laryngeal Cancer in the United States: Changes in Demographics, Patterns of Care, and Survival","volume":"116","author":"Hoffman","year":"2006","journal-title":"Laryngoscope"},{"key":"ref_2","unstructured":"Fitzmaurice, C., Allen, C., Barber, R.M., Barregard, L., Bhutta, Z.A., Brenner, H., Dicker, D.J., Chimed-Orchir, O., Dandona, R., and Dandona, L. (2017). Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study Global Burden of Disease Cancer Collaboration. JAMA Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4452","DOI":"10.1002\/cncr.27419","article-title":"A population-based study of therapy and survival for patients with head and neck cancer treated in the community","volume":"118","author":"Harlan","year":"2012","journal-title":"Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.ijrobp.2009.08.066","article-title":"T1N0 to T2N0 Squamous Cell Carcinoma of the Glottic Larynx Treated With Definitive Radiotherapy","volume":"78","author":"Chera","year":"2010","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1186\/1748-717X-7-193","article-title":"Definitive radiotherapy for early (T1-T2) Glottic Squamous cell carcinoma: A 20 year Cleveland clinic experience","volume":"7","author":"Khan","year":"2012","journal-title":"Radiat. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4029","DOI":"10.1200\/JCO.2001.19.20.4029","article-title":"T1-T2N0 squamous cell carcinoma of the glottic larynx treated with radiation therapy","volume":"19","author":"Mendenhall","year":"2001","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1097\/00005537-200011000-00007","article-title":"A Prospective Study of the Effects of Irradiation on the Carotid Artery","volume":"110","author":"Muzaffar","year":"2000","journal-title":"Laryngoscope"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jvs.2009.01.033","article-title":"Predictors of carotid artery stenosis after radiotherapy for head and neck cancers","volume":"50","author":"Chang","year":"2009","journal-title":"J. Vasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1200\/JCO.2002.20.1.282","article-title":"Increased risk of ischemic stroke after radiotherapy on the neck in patients younger than 60 years","volume":"20","author":"Dorresteijn","year":"2002","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1097\/00005537-200210000-00034","article-title":"Relative Risk of Stroke in Head and Neck Carcinoma Patients Treated With External Cervical Irradiation","volume":"112","author":"Haynes","year":"2002","journal-title":"Laryngoscope"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1002\/hed.23342","article-title":"Risk of fatal cerebrovascular accidents after external beam radiation therapy for early-stage glottic laryngeal cancer","volume":"36","author":"Mitra","year":"2014","journal-title":"Head Neck"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.ijrobp.2015.06.016","article-title":"Single Vocal Cord Irradiation: Image Guided Intensity Modulated Hypofractionated Radiation Therapy for T1a Glottic Cancer: Early Clinical Results","volume":"93","author":"Kwa","year":"2015","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.oraloncology.2015.02.003","article-title":"Carotid sparing intensity-modulated radiation therapy achieves comparable locoregional control to conventional radiotherapy in T1-2N0 laryngeal carcinoma","volume":"51","author":"Zumsteg","year":"2015","journal-title":"Oral Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.meddos.2015.08.004","article-title":"Clinical and dosimetric implications of intensity-modulated radiotherapy for early-stage glottic carcinoma","volume":"41","author":"Ward","year":"2016","journal-title":"Med. Dosim."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/1748-717X-5-74","article-title":"An investigation of intensity-modulated radiation therapy versus conventional two-dimensional and 3D-conformal radiation therapy for early stage larynx cancer","volume":"5","author":"Gomez","year":"2010","journal-title":"Radiat. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1002\/hed.20332","article-title":"Intensity-modulated radiation therapy in head and neck cancers: An update","volume":"29","author":"Lee","year":"2007","journal-title":"Head Neck"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4873","DOI":"10.1200\/JCO.2007.11.5501","article-title":"Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients","volume":"25","author":"Kam","year":"2007","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Nutting, C.M., Morden, J.P., Harrington, K.J., Urbano, T.G., Bhide, S.A., Clark, C., Miles, E.A., Miah, A.B., Newbold, K., and Tanay, M.A. (2011). Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): A phase 3 multicentre randomised controlled trial. Lancet Oncol.","DOI":"10.1016\/S1470-2045(10)70290-4"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Mohamed, A.S.R., Smith, B.D., Smith, J.B., Sevak, P., Malek, J.S., Kanwar, A., Browne, T., Gunn, G.B., Garden, A.S., and Frank, S.J. (2019). Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation. Laryngoscope.","DOI":"10.1002\/lary.27873"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Rosenthal, D.I., Fuller, C.D., Barker, J.L., Mason, B., Garcia, J.A., Lewin, J.S., Holsinger, F.C., Stasney, C.R., Frank, S.J., and Schwartz, D.L. (2010). Simple Carotid-Sparing Intensity-Modulated Radiotherapy Technique and Preliminary Experience for T1-2 Glottic Cancer. Int. J. Radiat. Oncol. Biol. Phys.","DOI":"10.1016\/j.ijrobp.2009.04.061"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s00405-013-2608-8","article-title":"Radiotherapy for T1a glottic cancer: the influence of smoking cessation and fractionation schedule of radiotherapy","volume":"271","author":"Mehilal","year":"2014","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ijrobp.2005.06.014","article-title":"Radiotherapy for early glottic carcinoma (T1N0M0): Results of prospective randomized study of radiation fraction size and overall treatment time","volume":"64","author":"Yamazaki","year":"2006","journal-title":"Int. J. Radiat. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1001\/archotol.132.1.59","article-title":"Results of surgical salvage after failure of definitive radiation therapy for early-stage squamous cell carcinoma of the glottic larynx","volume":"132","author":"Ganly","year":"2006","journal-title":"Arch. Otolaryngol. Head. Neck Surg."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Bledsoe, T.J., Park, H.S., Stahl, J.M., Yarbrough, W.G., Burtness, B.A., Decker, R.H., and Husain, Z.A. (2017). Hypofractionated Radiotherapy for Patients with Early-Stage Glottic Cancer: Patterns of Care and Survival. JNCI J. Natl. Cancer Inst., 109.","DOI":"10.1093\/jnci\/djx042"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.oraloncology.2017.07.013","article-title":"Patterns of fractionation for patients with T2N0M0 glottic larynx cancer undergoing definitive radiotherapy in the United States","volume":"72","author":"Stokes","year":"2017","journal-title":"Oral Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.ijrobp.2017.03.050","article-title":"Patterns of Care for Patients With Early-Stage Glottic Cancer Undergoing Definitive Radiation Therapy: A National Cancer Database Analysis","volume":"98","author":"Stokes","year":"2017","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1245\/s10434-007-9747-3","article-title":"The National Cancer Data Base: A Powerful Initiative to Improve Cancer Care in the United States","volume":"15","author":"Bilimoria","year":"2008","journal-title":"Ann. Surg. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/11\/12\/1996\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:41:38Z","timestamp":1760190098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/11\/12\/1996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,12]]},"references-count":27,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["cancers11121996"],"URL":"https:\/\/doi.org\/10.3390\/cancers11121996","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,12]]}}}