title: Three-dimensional conformal radiation therapy for refractory laryngeal granuloma.
abstract: OBJECTIVE
  The etiology of laryngeal granulomas is often multifactorial and the benefit of pharmacological therapy remains unclear. Anti-reflux treatment is only effective in granulomas definitely induced by gastroesophageal reflux. Steroid inhalation has shown favorable results but it is unclear whether it shortens the healing process. Surgical excision is associated with high recurrence rates. The aim of this study was to evaluate the role of 3-dimensional conformal radiation therapy (3DCRT) in the treatment of refractory laryngeal granuloma.
  
  
  METHODS
  The study was a retrospective review including all patients presenting to the Department of Radiation Oncology at Xijing Hospital from January 2004 to March 2007. We studied a total of 15 cases of refractory laryngeal granuloma that had recurred ≥2 times. Patients had previously been managed with voice rest, corticosteroids, antibiotics, antacids, surgery and botulinum toxin. All patients accepted surgical excision and immediate adjuvant 3DCRT at a total dose of 15 Gy over 5 days.
  
  
  RESULTS
  All patients were successfully treated with surgery and 3DCRT. There has been no granuloma recurrence in 3 years of follow-up.
  
  
  CONCLUSIONS
  3DCRT is a safe and effective therapy for refractory laryngeal granulomas, especially when other methods have failed.
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military University, Xi'an, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Wang
authors.forename: Mei
authors.initials: M
authors.lastname: Shi
authors.forename: Yuesheng
authors.initials: Y
authors.lastname: Xia
authors.forename: Shanquan
authors.initials: S
authors.lastname: Luo
authors.forename: Xuehai
authors.initials: X
authors.lastname: Fu
authors.forename: Feng
authors.initials: F
authors.lastname: Xiao
authors.forename: Jianping
authors.initials: J
authors.lastname: Li
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Deng
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Long
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D005260:Female; D006102:Granuloma, Laryngeal / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use
chemical_list: D018726:Anti-Dyskinesia Agents; D000893:Anti-Inflammatory Agents; D014221:Triamcinolone; D001905:Botulinum Toxins