Results of radiotherapy in squamous cell laryngeal cancer

Abstract

Background: Laryngeal cancer is a common type of head and neck cancer (HNC). Radiotherapy (RT) is a mainstay for curative treatment. Intensity-modulated RT (IMRT) is a standard technique today, as it provides of higher survival and local control and lower normal tissue toxicity. One of IMRT devices is helical tomotherapy (HT). The HT treatment results of HNC patients have been reported in few studies. We aimed to investigate the results of squamous cell laryngeal carcinoma patients treated with helical tomotherapy. Methods: Forty-five laryngeal cancer patients were selected according to the inclusion criteria. Radiotherapy (RT) plans were set in the Hi-Art HT planning system. Image-gated RT (IGRT) technique was used. Appropriate patients received simultaneous cisplatin. Treatment response rates were evaluated at the post-RT third and sixth months. Survival times were calculated with the Kaplan–Meier method. The factors affecting the treatment results were evaluated using Log-rank and Cox regression tests. A P value of less than 0.05 was accepted as statistically significant. Results: The median age was 65 (28–84) years. The median symptom duration was 6 (1–60) months. The RT dose for the early and the locally advanced disease was median 63 Gy (60.75–66) and 66 Gy (60–70), respectively. The RT interruption was median two (0-20) days. The patients were followed up to 25 (1–45) months. Grade 2 xerostomia and dysphagia rates were 55% and 7%, respectively. The 3-year estimates of overall survival (OS), disease-free survival (DFS), metastasis-free survival (DMFS), and locoregional recurrence-free survival (RRFS) were 71.7%, 60.4%, 84.9%, and 68.5%, respectively. In univariate analysis, the presence of N2 disease was a negative prognostic for DFS (P = 0.05) and DMFS (P = 0.003). RT interruption >2 days was a negative prognostic for OS (P = 0.005), DFS (P = 0.02), and RRFS (P = 0.023). In the multivariate analysis, symptom duration >6 months was found to be the only significant factor for DFS (P < 0.05). Conclusion: Intensity-modulated radiation with HT achieved comparable clinical outcomes with acceptable toxicity in laryngeal carcinoma.

Clinical Outcomes of Curative Intent Radiotherapy by Helical Tomotherapy for Laryngeal Squamous Cell Carcinoma: A Retrospective Analysis in a Tertiary Referral Center

“…A prospective study conducted by Chatterjee et al revealed favorable outcomes, with 5-year local recurrence-free survival rate of 75.1% using helical radiotherapy for early-stage laryngeal cancers [ 13 ]. Bolukbas et al investigated 45 patients with laryngeal cancer at any clinical stage, all of whom were treated with helical tomotherapy [ 14 ]. They reported that the 3-year OS and DFS rates were 71.7% and 60.4%, respectively, with acceptable radiation-induced toxicity.…”

“…Bolukbas et al also investigated the use of helical tomotherapy for treating 45 patients with LSCC. Their results indicated that the 3-year OS and DFS were 71.7% and 60.4%, respectively [ 14 ].…”

“…Bolukbas et al investigated 45 patients with laryngeal cancer at any clinical stage, all of whom were treated with helical tomotherapy [14]. They reported that the 3-year OS and DFS rates were 71.7% and 60.4%, respectively, with acceptable radiation-induced toxicity.…”