Effect of daily fraction size on laryngoesophageal dysfunction after chemoradiation for squamous cell carcinomas of the larynx and hypopharynx

Allen M. Chen, Sophia Hsu, Jessica Meshman, Robert Chin, Philip Beron, Elliot Abemayor, Maie St. John

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: The purpose of this study was to determine the effect of fraction size on laryngoesophageal dysfunction among patients treated by chemoradiotherapy for laryngeal and hypopharyngeal cancer. Methods: Forty patients underwent chemoradiotherapy for stage III/IV squamous cell carcinomas of the larynx and hypopharynx. Median radiation dose was 70 Gy (range, 69.3-70.4 Gy) with daily fractionation ranging from 2 Gy to 2.2 Gy. Results: When comparing 2 Gy versus >2 Gy daily fractionation, there was no difference in 2-year overall survival (71% vs 72%; p = .68), locoregional control (79% vs 77%; p = .43), or laryngectomy-free survival (60% vs 61%; p = .72). Use of 2 Gy versus >2 Gy fractionation improved laryngoesophageal dysfunction-free survival (2-year estimates, 49% vs 27%; p = .07). Patient-reported voice and swallowing were improved with the former. Conclusion: As the importance of a functional larynx becomes recognized as an endpoint for patients treated by voice preservation, the results of our study help refine treatment guidelines.

Original languageEnglish (US)
JournalHead and Neck
DOIs
StateAccepted/In press - 2017

Keywords

  • Chemoradiotherapy
  • Dysphagia
  • Laryngeal cancer
  • Swallowing
  • Voice preservation

ASJC Scopus subject areas

  • Otorhinolaryngology

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