Feasibility of Intensity-Modulated and Image-Guided Radiotherapy for Functional Organ Preservation in Locally Advanced Laryngeal Cancer

Authors

Nam P. Nguyen, University of Arizona
Alexander Chi, West Virginia University
Michael Betz, University Hospitals of Geneva
Fabio Almeida, Southwest PET/CT Institute
Paul Vos, East Carolina University
Rick Davis, University of Arizona
Benjamin Slane, University of Arizona
Misty Ceizyk, University of Arizona
Dave Abraham, University of Arizona
Lexie Smith-Raymond, University of Arizona
Michelle Stevie, University of Arizona
Siyoung Jang, University of Pittsburgh
Steven Gelumbauskas, University of Arizona
Vincent Vinh-Hung, University Hospitals of Geneva

Author ORCID Identifier

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https://orcid.org/0000-0002-9763-5867

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https://orcid.org/0000-0001-9996-5627

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https://orcid.org/0000-0002-6403-6120

Document Type

Article

Publication Date

2012

College/Unit

School of Medicine

Department/Program/Center

Radiation Oncology

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.

Digital Commons Citation

Nguyen, Nam P.; Chi, Alexander; Betz, Michael; Almeida, Fabio; Vos, Paul; Davis, Rick; Slane, Benjamin; Ceizyk, Misty; Abraham, Dave; Smith-Raymond, Lexie; Stevie, Michelle; Jang, Siyoung; Gelumbauskas, Steven; and Vinh-Hung, Vincent, "Feasibility of Intensity-Modulated and Image-Guided Radiotherapy for Functional Organ Preservation in Locally Advanced Laryngeal Cancer" (2012). Faculty & Staff Scholarship. 2680.
https://researchrepository.wvu.edu/faculty_publications/2680

Source Citation

Nguyen NP, Chi A, Betz M, Almeida F, Vos P, Davis R, et al. (2012) Feasibility of Intensity-Modulated and Image-Guided Radiotherapy for Functional Organ Preservation in Locally Advanced Laryngeal Cancer. PLoS ONE 7(8): e42729. https://doi.org/10.1371/journal.pone.0042729

Comments

© Nguyen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.