Dosimetric Predictors of Laryngeal Edema

Definitive radiochemotherapy of advanced head and neck cancer with carboplatin and paclitaxel

“…Laryngeal edema was a common late toxicity exclusively for ccb patients and was more common in hypopharyngeal (26%) than in oropharyngeal carcinomas (14%). According to Sanguinetti et al [19], the mean laryngeal dose should be kept below 43.5 Gy to minimize ≥ grade 2 laryngeal edema. Although dosimetric data were not available for all patients, the radiotherapy technique used in this study did not allow this dose constraint to be maintained.…”

Evaluation of Larynx-Sparing Techniques With IMRT When Treating the Head and Neck

“…Early data from a study by Feng et al (11) appear to reinforce this by suggesting that a mean dose threshold of 50 Gy to the larynx correlates with dysphagia, although they found no evidence of a similar effect at a dose <40 Gy. Sanguineti et al (12) recommended a mean laryngeal dose threshold of 43.5 Gy and a volume receiving 50% of prescribed dose of <27% to minimize laryngeal edema. All these constraints were comfortably achieved in this study for all patients.…”

Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

“…In the present cohort, due to positive lymph nodes, the vast majority of patients (20/22) received a radiation dose of 43.5 Gy and higher to the larynx, which has been described in the literature as cutoff value for developing voice problems or chronic edema [4,5]. Voice problems can also occur due to changes in saliva production and lubrication, mainly as a result of radiation dose to the parotid gland and the laryngeal mucosa, which can lead to insufficient lubrication/dryness of the vocal folds [37,55].…”

“…Furthermore, dysphagia can adversely affect compliance to treatment and post-treatment recovery (e.g., because of aspiration problems), and can deteriorate patient's social contacts and quality of life (QoL) [3]. Since radiation fields frequently encompass the larynx, also substantial effects on voice quality have been noted, which are correlated to the RT dose to the larynx [4][5][6]. Combination with chemotherapy aggravates these negative effects on patients' speech, daily life activities, and again QoL [7][8][9][10][11][12][13].…”