title: Intensity-modulated radiotherapy for locally advanced cancers of the larynx and hypopharynx.
abstract: BACKGROUND
  Limited data evaluate intensity-modulated radiotherapy (IMRT) for cancers of the hypopharynx and larynx. We report clinical outcomes and failure patterns for these patients.
  
  
  METHODS
  Between September 2001 and December 2007, 42 patients with squamous cell carcinoma (SCC) of the hypopharynx (n = 23) and larynx (n = 19) underwent IMRT, 11 postoperatively and 31 definitively. Thirty-six received systemic therapy. Median follow-up was 30 months among surviving patients.
  
  
  RESULTS
  Three local failures occurred within the high-dose region and 3 occurred in regional nodes. Seven patients developed distant metastasis as the initial failure. Three-year actuarial estimates of locoregional control, freedom from distant metastasis, and overall survival rates were, respectively, 80%, 72%, and 46%.
  
  
  CONCLUSIONS
  IMRT provides good locoregional control for SCC of the hypopharynx and larynx compared with historical controls. Locoregional relapses occurred in the high-dose volumes, suggesting adequate target volume delineation. Hypopharyngeal tumors, which fare worse than laryngeal tumors, warrant investigation of more aggressive treatment.
authors.affiliation: Department of Radiation Oncology, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Daly
authors.forename: Quynh-Thu
authors.initials: QT
authors.lastname: Le
authors.forename: Anshu K
authors.initials: AK
authors.lastname: Jain
authors.forename: Peter G
authors.initials: PG
authors.lastname: Maxim
authors.forename: Annie
authors.initials: A
authors.lastname: Hsu
authors.forename: Billy W
authors.initials: BW
authors.lastname: Loo
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kaplan
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Fischbein
authors.forename: A Dimitrios
authors.initials: AD
authors.lastname: Colevas
authors.forename: Harlan
authors.initials: H
authors.lastname: Pinto
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011832:Radiation Injuries / Q000503:physiopathology / Q000517:prevention & control; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult