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

doi:10.1016/j.oraloncology.2015.02.003

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

2015

Published Web Location

https://doi.org/10.1016/j.oraloncology.2015.02.003

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 1cm 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.

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