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Intensity-modulated radiotherapy (55 Gy in 20 fractions) for high-grade laryngeal dysplasia: report of acute toxicity and functional outcome

Published online by Cambridge University Press:  22 February 2019

J Kovarik ,
M Bhabra ,
A W Tin ,
G Shaikh  and
M S Iqbal
J Kovarik
Affiliation:
Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
M Bhabra
Affiliation:
ENT Department, Sunderland Royal Hospital, UK
A W Tin
Affiliation:
Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
G Shaikh
Affiliation:
Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
M S Iqbal*
Affiliation:
Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
*
Author for correspondence: Dr Muhammad Shahid Iqbal, Department of Clinical Oncology, Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK E-mail: Shahid.iqbal@nhs.net
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Abstract

Objective

Radiotherapy is an option to treat high-grade laryngeal dysplasia. This study aimed to evaluate the use of intensity-modulated radiotherapy, 55 Gy in 20 daily fractions, in treating this disease.

Methods

Acute toxicity was evaluated in all 14 patients treated. In 10 patients, functional voice outcome was measured using the Voice Handicap Index, and the Grade, Roughness, Breath, Asthenia, Strain (‘GRBAS’) scale. These measurements were performed pre-treatment and three months after intensity-modulated radiotherapy.

Results

All but one patient managed to complete radiotherapy. Acute toxicity was significant (one patient developed grade 4 and three patients developed grade 3 dysphagia). Four patients required hospital admission. In 9 out of 10 patients, radiotherapy improved voice quality.

Conclusion

This radiotherapy regimen using intensity-modulated radiotherapy for laryngeal dysplasia is feasible and provided excellent functional outcome, but acute toxicity was significant. Dose de-escalation can be considered in the framework of clinical trials.

Keywords

Intensity-Modulated RadiotherapyLaryngeal Dysplasia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 3 , March 2019 , pp. 241 - 244
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr M S Iqbal takes responsibility for the integrity of the content of the paper

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