Published in:
01-03-2015 | Original article
Intensity-modulated radiotherapy for laryngeal and hypopharyngeal cancer
Minimization of late dysphagia without jeopardizing tumor control
Published in: Strahlentherapie und Onkologie | Issue 3/2015
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Purpose
The purpose of this work was to retrospectively determine the value of intensity-modulated radiotherapy (IMRT) in patients with laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC), on outcome and treatment-related toxicity compared to 3-dimensional conformal radiotherapy (3D-CRT).
Materials and methods
A total of 175 consecutive patients were treated between 2007 and 2012 at our institution with curative intent RT and were included in this study: 90 were treated with 3D-CRT and 85 with IMRT. Oncologic outcomes were estimated using Kaplan–Meier statistics; acute and late toxicities were scored according to the Common Toxicity Criteria for Adverse Events scale v 3.0.
Results
Median follow-up was 35 months (range 32–42 months; 95% confidence interval 95 %). Two-year disease-free survival did not vary, regardless of the technique used (69 % for 3D-CRT vs. 72 %; for IMRT, p = 0.16). Variables evaluated as severe late toxicities were all statistically lower with IMRT compared with 3D-CRT: xerostomia (0 vs. 12 %; p < 0.0001), dysphagia (4 vs. 26 %; p < 0.0001), and feeding-tube dependency (1 vs 13 %; p = 0.0044). The rates of overall grade ≥ 3 late toxicities for the IMRT and 3D-CRT groups were 4.1 vs. 41.4 %, respectively (p < 0.0001).
Conclusion
IMRT for laryngeal and hypopharyngeal cancer minimizes late dysphagia without jeopardizing tumor control and outcome.