Carotid sparing intensity-modulated radiation therapy achieves comparable locoregional control to conventional radiotherapy in T1-2N0 laryngeal carcinoma

Zachary S. Zumsteg, Nadeem Riaz, Sana Jaffery, Man Hu, Daphna Gelblum, Ying Zhou, Borys Mychalczak, Michael J. Zelefsky, Suzanne Wolden, Shyam Rao, Nancy Y. Lee

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Background Although intensity-modulated radiotherapy (IMRT) is a standard of care for many head and neck cancers, its use for carotid-sparing (CS) therapy in early-stage laryngeal carcinoma is controversial. Methods 330 consecutive patients with early-stage laryngeal carcinoma were treated from 1/1989 to 5/2011, including 282 conventional radiotherapy (CRT) and 48 CS-IMRT patients. The median follow-up was 43 (CS-IMRT) and 66 (CRT) months. Results There was no difference in local failure rates comparing patients undergoing CS-IMRT with CRT, with 3-year local control rates of 88% vs. 89%, respectively (p = 0.938). Using a 1 cm circumferential margin, the average dose to the left and right carotid arteries was 48.3 and 47.9 Gy, respectively. 88% of locoregional recurrences involved the ipsilateral true vocal cord, including all local recurrences in the IMRT group. Conclusions These results warrant further prospective evaluation of CS-IMRT for early-stage glottic larynx cancer.

Original languageEnglish (US)
Pages (from-to)716-723
Number of pages8
JournalOral Oncology
Volume51
Issue number7
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

Keywords

  • Carotid sparing
  • Early stage laryngeal carcinoma
  • Glottic cancer
  • IMRT

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

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    Zumsteg, Z. S., Riaz, N., Jaffery, S., Hu, M., Gelblum, D., Zhou, Y., Mychalczak, B., Zelefsky, M. J., Wolden, S., Rao, S., & Lee, N. Y. (2015). Carotid sparing intensity-modulated radiation therapy achieves comparable locoregional control to conventional radiotherapy in T1-2N0 laryngeal carcinoma. Oral Oncology, 51(7), 716-723. https://doi.org/10.1016/j.oraloncology.2015.02.003