Abstract
Objectives:
Radiation is an integral part of the treatment of head and neck cancer. However, side effects and toxicities are high and lead to dysphagia and dysphagia related morbidity in a significant proportion of patients. There has been interest in intensity modulated radiation therapy (IMRT) to decrease these side effects while preserving locoregional control and survival.
Methods:
We performed a retrospective review of patients who underwent definitive radiation for laryngeal squamous cell carcinoma (SCCa) at MUSC. Primary endpoints included: gastrostomy (PEG) tube dependence 1 year after radiation start, time to PEG tube removal, weight loss during treatment, Radiation Therapy Oncology Group (RTOG) toxicity profiles, disease-free survival, and overall survival.
Results:
Of 315 patients identified in the database, 74 had primaries of the larynx and underwent definitive radiation therapy. Twenty-four and 50 patients were treated with conventional radiation (3D-CRT) and IMRT respectively. Data analysis revealed that PEG tube dependence after treatment initiation, time to PEG tube removal, weight loss during treatment, and skin and larynx RTOG toxicity scores did not markedly differ between IMRT and 3D-CRT. There was a significantly lower rate of ≥3 mucous membrane toxicity in patients treated with IMRT versus 3D-CRT (P = 0.0030). Lastly, there were no significant differences in disease free survival (P = 0.9318) or overall survival (P = 0.5586) between the 2 groups.
Conclusions:
The use of IMRT techniques does not compromise locoregional control or overall survival compared to 3D-CRT. IMRT may also improve mucous membrane toxicity and other toxicity scores compared to 3D-CRT.
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