Hyperfractionated irradiation for early laryngeal cancer

The aim of the study was to evaluate the phenomena of early and late toxicity, immediate and long-term results of treatment of patients with localized laryngeal cancer who received a radical course of conformal radiation therapy in the hyperfractionation mode with a uniform fragmentation of the daily dose of 1+1 Gy to 64-66 Gy in an independent version. The material is presented by the results of treatment of 62 patients with newly diagnosed, histologically verified diagnosis of squamous cell carcinoma of the larynx T1-2N0M0. 62 (100%) patients received the planned dose of radiation therapy. Grade 3 mucositis developed in 30 (48.3%) patients. In 32 (51.7%) patients, grade 1-2 mucositis was registered. The intragroup analysis revealed differences in the level of early toxicity depending on the T-stage of the disease, due to the volume of irradiation at the first stage of radiation therapy (p=0.03). Cutaneous toxicity in 60 (96.8%) patients was limited to grade 1-2. Wet epidermis was registered in 2 (3.2%) patients. The average follow-up period for the group was 4.4±2.3 years. The overall 1-year survival rates were 96.7%, 2-year - 93.0%, 3-year - 90.9%. Local and / or regional relapse during the entire follow-up period was registered in 15 (24.1%) patients. The level of 1-year locoregional control was 83.3%, 2-year - 81.4%, 3-year - 79.1%. Subglottic spread of the tumor (p=0.07) and the initial tumor process T2 (p=0.12) were identified as worsening the prognosis of treatment. Late complications of radiation therapy were registered in 5 (8.0%) patients. Late xerostomia of the 2nd degree 12 months after completion of treatment was observed in 17 (27.4%) patients. All cases of late xerostomia were observed when intact groups of the neck lymphatic collectors were included in the irradiation volume. The findings suggest that radiation therapy in the hyperfractionation regimen is well tolerated, but more aggressive treatment options should be offered for patients with a relatively poor prognosis.