title: Intensity-modulated radiotherapy for laryngeal and hypopharyngeal cancer: minimization of late dysphagia without jeopardizing tumor control.
abstract: OBJECTIVE
  The purpose of this work was to retrospectively determine the value of intensity-modulated radiotherapy (IMRT) in patients with laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC), on outcome and treatment-related toxicity compared to 3-dimensional conformal radiotherapy (3D-CRT).
  
  
  METHODS
  A total of 175 consecutive patients were treated between 2007 and 2012 at our institution with curative intent RT and were included in this study: 90 were treated with 3D-CRT and 85 with IMRT. Oncologic outcomes were estimated using Kaplan-Meier statistics; acute and late toxicities were scored according to the Common Toxicity Criteria for Adverse Events scale v 3.0.
  
  
  RESULTS
  Median follow-up was 35 months (range 32-42 months; 95% confidence interval 95%). Two-year disease-free survival did not vary, regardless of the technique used (69% for 3D-CRT vs. 72%; for IMRT, p = 0.16). Variables evaluated as severe late toxicities were all statistically lower with IMRT compared with 3D-CRT: xerostomia (0 vs. 12%; p < 0.0001), dysphagia (4 vs. 26 %; p < 0.0001), and feeding-tube dependency (1 vs 13%; p = 0.0044). The rates of overall grade ≥ 3 late toxicities for the IMRT and 3D-CRT groups were 4.1 vs. 41.4%, respectively (p < 0.0001).
  
  
  CONCLUSIONS
  IMRT for laryngeal and hypopharyngeal cancer minimizes late dysphagia without jeopardizing tumor control and outcome.
authors.affiliation: Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, 1 avenue Irène Joliot-Curie, 31059, Toulouse, Cedex 9, France, Modesto.anouchka@iuct-oncopole.fr.
authors.forename: Anouchka
authors.initials: A
authors.lastname: Modesto
authors.forename: Anne
authors.initials: A
authors.lastname: Laprie
authors.forename: Laure
authors.initials: L
authors.lastname: Vieillevigne
authors.forename: Pierre
authors.initials: P
authors.lastname: Graff
authors.forename: Jérôme
authors.initials: J
authors.lastname: Sarini
authors.forename: Sébastien
authors.initials: S
authors.lastname: Vergez
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Delord
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Farenc
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Vigarios
authors.forename: Thomas
authors.initials: T
authors.lastname: Filleron
authors.forename: Michel
authors.initials: M
authors.lastname: Rives
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000532:radiotherapy*; D007822:Laryngeal Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies