Intensity-Modulated Radiotherapy (IMRT) following Conservative Surgery of the Supraglottic Region: Impact on Functional Outcomes

Abstract

The aim of the present study was to investigate the role of intensity-modulated radiotherapy (IMRT) on the toxicity profile of patients treated with conservative surgery (CS) of the supraglottic (SG) region. Data on patients treated with CS and postoperative radiotherapy (PORT)-IMRT were prospectively collected. Results. In total, 20 patients were analyzed. Of these, six patients (35%) required the positioning of a temporary tracheostomy. The functional larynx preservation rate was 95%. Females had a higher risk of both endoscopic intervention and chondronecrosis, while the median age was significantly higher in patients requiring enteral nutrition. The incidence of long-term severe toxicities was lower in patients treated with IMRT than in the historical 3D-CRT cohort. Patients who had received PORT-IMRT achieved a lower rate of permanent laryngeal and swallowing dysfunctions. Overall, results from the comparison with the historical 3D-CRT cohort favor the IMRTs.

Post-operative intensity-modulated vs 3D conformal radiotherapy after conservative surgery for laryngeal tumours of the supraglottic region: a dosimetric analysis on 20 patients

“…In a previously published study by our group 20 , the toxicity profile of 20 patients treated with IMRT was compared to that of 32 patients who received 3D-CRT. Compared to the 3D-CRT group, patients treated with IMRT experienced a lower rate of permanent aspiration/pneumonia (6% vs 0%, respectively), laryngeal stenosis requiring endoscopic dilatation (21% vs 15%, respectively), laryngeal necrosis (6% vs 0%, respectively), and permanent tracheostomy (12.5% vs 5%, respectively).…”

Outcomes of Supracricoid Partial Laryngectomy Performed in the United States: A Systematic Review

“…Additionally, supraglottic cancers amenable to CHP are more likely to demonstrate cervical lymph node involvement that would require postoperative radiation 27 . Administering radiation after SCPL is typically not advised, as it further exacerbates the higher rates of dysphagia and respiratory dysfunction associated with surgical resection of the supraglottic region 28 . Thus, the disproportionate usage of CHEP over CHP reconstruction may also represent a sample selection bias in favor of disease that does not require postoperative radiation.…”

“…27 Administering radiation after SCPL is typically not advised, as it further exacerbates the higher rates of dysphagia and respiratory dysfunction associated with surgical resection of the supraglottic region. 28 Thus, the disproportionate usage of CHEP over CHP reconstruction may also represent a sample selection bias in favor of disease that does not require postoperative radiation. The frequencies of CHEP and CHP reconstructions observed in this review are similar to those reported in Europe.…”