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Feasibility of intensity-modulated and image-guided radiotherapy for functional organ preservation in locally advanced laryngeal cancer

Nguyen, NP and Chi, A and Betz, M and Almeida, F and Vos, P and Davis, R and Slane, B and Ceizyk, M and Abraham, D and Smith-Raymond, L and Stevie, M and Jang, S and Gelumbauskas, S and Vinh-Hung, V (2012) Feasibility of intensity-modulated and image-guided radiotherapy for functional organ preservation in locally advanced laryngeal cancer. PLoS ONE, 7 (8).

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Abstract

Purpose: The study aims to assess the feasibility of intensity-modulated and image-guided radiotherapy (IMRT, and IGRT, respectively) for functional preservation in locally advanced laryngeal cancer. A retrospective review of 27 patients undergoing concurrent chemoradiation for locally advanced laryngeal cancers (8 IMRT, 19 IGRT) was undertaken. In addition to regular clinical examinations, all patients had PET imaging at 4 months and 10 months after radiotherapy, then yearly. Loco-regional control, speech quality and feeding-tube dependency were assessed during follow-up visits. Results: At a median follow-up of 20 months (range 6-57 months), four out of 27 patients (14.8%) developed local recurrence and underwent salvage total laryngectomy. One patient developed distant metastases following salvage surgery. Among the 23 patients who conserved their larynx with no sign of recurrence at last follow-up, 22 (95%) reported normal or near normal voice quality, allowing them to communicate adequately. Four patients (14.8%) had long-term tube feeding-dependency because of severe dysphagia (2 patients) and chronic aspiration (2 patients, with ensuing death from aspiration pneumonia in one patient). Conclusions and Clinical Relevance: Functional laryngeal preservation is feasible with IMRT and IGRT for locally advanced laryngeal cancer. However, dysphagia and aspiration remain serious complications, due most likely to high radiation dose delivery to the pharyngeal musculatures. © 2012 Nguyen et al.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Nguyen, NP
Chi, A
Betz, M
Almeida, F
Vos, P
Davis, R
Slane, B
Ceizyk, M
Abraham, D
Smith-Raymond, L
Stevie, M
Jang, S
Gelumbauskas, S
Vinh-Hung, V
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorMoon, ChulsoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 20 August 2012
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 7
Number: 8
DOI or Unique Handle: 10.1371/journal.pone.0042729
Schools and Programs: School of Medicine > Radiation Oncology
Refereed: Yes
Other ID: NLM PMC3423414
PubMed Central ID: PMC3423414
PubMed ID: 22916151
Date Deposited: 19 Oct 2012 18:18
Last Modified: 07 Feb 2019 02:55
URI: http://d-scholarship.pitt.edu/id/eprint/15889

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