Hypo-Fractionated Radiotherapy for Laryngeal Cancer; is Linac Based Treatment Better?.

Corresponding Author:
Dr. Suresh Kumar K.,
Additional Professor,
Department of Radiotherapy,
Cancer Care Center,
Government Medical College,
Kottayam-686008, Kerala, India.
E-mail: drsureshkumar74@gmail.com

ABSTRACT

BACKGROUND

Carcinoma larynx is the most common malignancy of the upper aero digestive tract. 75% of larynx cancers are attributable to cigarette smoking and alcohol use. Squamous cell carcinoma constitutes 95% of all malignant neoplasms of the larynx. Irradiation is the initial treatment for T1 and T2 lesions, and surgery is reserved for salvage after radiation therapy failure. Hypo fractionated radiotherapy (>2.0 Gy/fraction) has shown comparable local control to conventional radiation in carcinoma Larynx.

METHODS

A total of 59 patients, newly diagnosed with stage I and II squamous cell carcinoma of glottic larynx who attended the OP clinic of Department of Radiation Oncology, of Kottayam Medical College, from November 2016 to November 2017 who were intended to receive radical treatment with a hypo fractionated regimen of radiotherapy were analysed for local control and toxicity.

RESULTS

Loco regional control at 1 year of treatment is 93.2% and Overall survival is 96.61% and is comparable to published literature data. Majority of the patients in the study had grade 1 - 2 dysphagia, grade 2 - 3 dermatitis, grade 2 - 3 laryngeal mucositis. During 6^th week, there was significantly higher incidence of grade 2 and 3 mucositis among patients treated in cobalt 60 machine in 28 out of 31 patients, (90.3%) as compared to linear accelerator-based treatment where 17 out of 28 patients (60.7%) had grade 2 and 3 mucositis.

CONCLUSIONS

Hypo fractionated radiotherapy is a safe alternative for conventionally fractionated radiotherapy by reducing overall treatment time by 1 week without affecting locoregional control and survival. It also reduces the socio-economic burden. However linear accelerator-based treatment has better toxicity profile than Cobalt 60 treatment in hypo fractionated radiotherapy for Carcinoma Larynx.

KEY WORDS

Laryngeal Cancer, Hypo-Fractionation, Radiotherapy, Linear Accelerator