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Publications

Journal Article Epublish

PubMed: 42187576 DOI: 10.3390/curroncol33050259

Global Disparities and Trends in Radiotherapy for Early-Stage Glottic Cancer.

Curr Oncol 33(5)

Authors: Issa Mohamad, Shatha Abu Taha, Ahmad Bushehri, Bassem Youssef, Enis Ozyar, Ibrahim Alotain, Ibrahim Abu-Gheida, Mohammed Aldehaim, Carlton Johnny, Layth Mula-Hussain, Majed Alghamdi, Mohamed Shelan, Mohammed Al Dohan, Nadeem Pervez, Olgun Elicin, Saad Alrashidi, Wael El-Sheshtawy, Shoukri Temraz, Zineb Dahbi, Ahmed Abbasi, Abdulrahman Sumaida, Hikmat Abdel-Razeq, Khawla Ammar, Akram Al-Ibraheem, Ali Hosni

Affiliations

  • Department of Radiation Oncology, King Hussein Cancer Center, Amman 11941, Jordan.
  • Department of Radiation Oncology, Kuwait Cancer Control Center, Kuwait City 7065, Kuwait.
  • Department of Radiation Oncology, American University of Beirut Medical Centre, Beirut 11-0236, Lebanon.
  • Department of Radiation Oncology, Acibadem MAA University School of Medicine, Istanbul 34457, Turkey.
  • Department of Radiation Oncology, King Fahad Specialist, Dammam 31444, Saudi Arabia.
  • Department of Radiation Oncology, Burjeel Medical City, Abu Dhabi 92510, United Arab Emirates.
  • Emirates Oncology Society, Dubai 6600, United Arab Emirates.
  • Department of Radiation Oncology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia.
  • College of Medicine, Alfaisal University, Riyadh 50927, Saudi Arabia.
  • Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada.
  • Division of Radiation Oncology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 4E6, Canada.
  • Radiation Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah 11426, Saudi Arabia.
  • College of Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah 3660, Saudi Arabia.
  • Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, 3010 Bern, Switzerland.
  • Department of Radiation Oncology, King Fahad Medical City, Riyadh 11525, Saudi Arabia.
  • Department of Radiation Oncology, Shifa Tameer- e-Miller University, Islamabad 44000, Pakistan.
  • Department of Clinical Oncology, Al-Azhar University, Cairo 11827, Egypt.
  • Clinical Oncology Department, Mansoura University Hospital, Mansour 35516, Egypt.
  • Department of Radiation Oncology, Mohammed University VI of Health, and Sciences, Casablanca 27182, Morocco.
  • Department of Radiation Oncology, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan.
  • Radiation Oncology Department, Tawam Hospital, Al Ain 15258, United Arab Emirates.
  • Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan.
  • Office of Scientific Affairs and Research, Survey Unit, King Hussein Cancer Center, Amman 11941, Jordan.
  • Department of Nuclear Medicine, King Hussein Cancer Center, Amman 11941, Jordan.
  • Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada.

Abstract

We evaluated global radiotherapy practices in the management of early-stage (AJCC/UICC 8th edition stages I-II) glottic cancer (ESGC). A cross-sectional online survey was conducted in March 2025 across centers worldwide. Data was collected on clinical practices, including staging, CT simulation, target volumes delineation, organs-at-risk contouring, radiotherapy techniques, dose and fractionation schedules, treatment delivery techniques, and image guidance practices. A total of 181 responses were received, primarily from Asia (41.4%) and Europe (24.3%). Most respondents were from non-academic public centers (44.2%), with multidisciplinary team involvement reported by 84.5%. Head and neck CT scan was the most used staging modality (80.1%). Intensity-Modulated Radiation Therapy was the most common planning technique (82.9%). Hypofractionated radiotherapy schedules predominated for T1 (84%) and T2 (72.4%) disease. T1a was typically treated with whole-larynx target volume (72.4%). Use of ipsilateral involved vocal cord irradiation varied by geographical region (p = 0.015), being most common in North America (44.8%) and Europe (38.6%). Accelerated fractionation for T2 also differed significantly (p < 0.001), with the highest use reported in North America (41.4%). Daily Cone-Beam Computed Tomography was acquired by (58.2%). In total, 70% of respondents expressed interest in the results of a future phase III randomized trial comparing stereotactic body radiation therapy to conventional radiotherapy. Significant global variations in radiotherapy practices for ESGC were observed, likely reflecting disparities in access and differences in institutional protocols. The development and implementation of standardized, evidence-based global guidelines are essential to harmonize care, minimize toxicity, and improve outcomes for patients with ESGC.

MeSH

Radiotherapy, Neoplasms, Therapeutics