Comparison of Intensity-modulated Radiation Therapy (IMRT) and Conventional Fields (CF) in the Treatment of Squamous Cell Carcinoma of the Larynx

Abstract

Results: Overall local control (LC) and LC for Stages T2/T3 and T4 were 49%, 63%, and 43% at 5 years, respectively. Five-year LC forpatientstreatedwith RTpreoperatively, postoperatively,and with RTalonewere61%,65%,and37%,respectively. Overall 5-year LC, neckcontrol,andlocal-regionalcontrolinitiallyand aftersalvage of failureswere 49%,82%,45%and 51%,87%,50%, respectively.Overallandcause-specificprobabilitiesof survivalat5yearswere 30%and 41%,respectively.The5-yearprobability of distant metastasis-freesurvivalwas71%.Therate of severe(GradeIII or GradeIV)complications was33%,most ofwhich were ocular. There were 2 neck failures (9%) in 22 clinical N0 patients not receiving ENI, and 1 neck failure (4%) in 23 clinical N0 patients who received ENI. Conclusions: SCCa of the maxillary sinus typically presents with advanced-stage disease. In resectable patients, we recommend surgical resection followed by postoperative RT to doses between 64.8 and 74.4 Gy at 1.2 Gy per fraction twice daily. RT alone to 74.4 Gy at 1.2 Gy twice daily and concomitant weekly cisplatin is recommended in patients with unresectable disease. Unilateral ENI is recommended in patients with T3/T4 primaries, and bilateral ENI in patients with large or recurrent primaries, or primaries that cross the midline.