title: Effect of daily fraction size on laryngoesophageal dysfunction after chemoradiation for squamous cell carcinomas of the larynx and hypopharynx.
abstract: The purpose of this study was to determine the effect of fraction size on laryngoesophageal dysfunction among patients treated by chemoradiotherapy for laryngeal and hypopharyngeal cancer.
  
  
  
  Forty patients underwent chemoradiotherapy for stage III/IV squamous cell carcinomas of the larynx and hypopharynx. Median radiation dose was 70 Gy (range, 69.3-70.4 Gy) with daily fractionation ranging from 2 Gy to 2.2 Gy.
  
  
  
  When comparing 2 Gy versus >2 Gy daily fractionation, there was no difference in 2-year overall survival (71% vs 72%; p = .68), locoregional control (79% vs 77%; p = .43), or laryngectomy-free survival (60% vs 61%; p = .72). Use of 2 Gy versus >2 Gy fractionation improved laryngoesophageal dysfunction-free survival (2-year estimates, 49% vs 27%; p = .07). Patient-reported voice and swallowing were improved with the former.
  
  
  
  As the importance of a functional larynx becomes recognized as an endpoint for patients treated by voice preservation, the results of our study help refine treatment guidelines. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1322-1326, 2017.
authors.affiliation: Department of Radiation Oncology, University of California - Los Angeles, David Geffen School of Medicine, Los Angeles, California.
authors.forename: Allen M
authors.identifier: 0000-0002-4582-712X
authors.initials: AM
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, University of California - Los Angeles, David Geffen School of Medicine, Los Angeles, California.
authors.forename: Sophia
authors.initials: S
authors.lastname: Hsu
authors.affiliation: Department of Radiation Oncology, University of California - Los Angeles, David Geffen School of Medicine, Los Angeles, California.
authors.forename: Jessica
authors.initials: J
authors.lastname: Meshman
authors.affiliation: Department of Radiation Oncology, University of California - Los Angeles, David Geffen School of Medicine, Los Angeles, California.
authors.forename: Robert
authors.initials: R
authors.lastname: Chin
authors.affiliation: Department of Radiation Oncology, University of California - Los Angeles, David Geffen School of Medicine, Los Angeles, California.
authors.forename: Philip
authors.initials: P
authors.lastname: Beron
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of California - Los Angeles, David Geffen School of Medicine, Los Angeles, California.
authors.forename: Elliot
authors.initials: E
authors.lastname: Abemayor
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of California - Los Angeles, David Geffen School of Medicine, Los Angeles, California.
authors.forename: Maie
authors.initials: M
authors.lastname: St John
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000379:methods; D016208:Databases, Factual; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D004947:Esophagus / Q000503:physiopathology / Q000528:radiation effects; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007830:Larynx / Q000503:physiopathology / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: chemoradiotherapy; dysphagia; laryngeal cancer; swallowing; voice preservation