Intensity-Modulated Radiotherapy (IMRT) following Conservative Surgery of the Supraglottic Region: Impact on Functional Outcomes

Daniela Alterio; Simona Marani; Valeria Zurlo; Stefano Filippo Zorzi; Annamaria Ferrari; Stefania Volpe; Francesco Bandi; Sabrina Vigorito; Maria Giulia Vincini; Sara Gandini; Aurora Gaeta; Cristiana Iuliana Fodor; Alessia Casbarra; Mattia Zaffaroni; Anna Starzyńska; Liliana Belgioia; Mohssen Ansarin; Cynthia Aristei; Barbara Alicja Jereczek-Fossa

doi:10.3390/cancers14112600

Intensity-Modulated Radiotherapy (IMRT) following Conservative Surgery of the Supraglottic Region: Impact on Functional Outcomes

Cancers (Basel). 2022 May 24;14(11):2600. doi: 10.3390/cancers14112600.

Authors

Daniela Alterio¹, Simona Marani¹, Valeria Zurlo², Stefano Filippo Zorzi², Annamaria Ferrari¹, Stefania Volpe^{1

3}, Francesco Bandi², Sabrina Vigorito⁴, Maria Giulia Vincini¹, Sara Gandini⁵, Aurora Gaeta⁵, Cristiana Iuliana Fodor¹, Alessia Casbarra¹, Mattia Zaffaroni¹, Anna Starzyńska⁶, Liliana Belgioia^{7

8}, Mohssen Ansarin², Cynthia Aristei⁹, Barbara Alicja Jereczek-Fossa^{1

3}

Affiliations

¹ Division of Radiation Oncology, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20141 Milan, Italy.
² Department of Otolaryngology and Head and Neck Surgery, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20141 Milan, Italy.
³ Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy.
⁴ Unit of Medical Physics, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20141 Milan, Italy.
⁵ Department of Experimental Oncology, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20141 Milan, Italy.
⁶ Department of Oral Surgery, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
⁷ Radiation Oncology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genova, Italy.
⁸ Health Science Department (DISSAL), University of Genoa, 16132 Genova, Italy.
⁹ Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, 06123 Perugia, Italy.

Abstract

The aim of the present study was to investigate the role of intensity-modulated radiotherapy (IMRT) on the toxicity profile of patients treated with conservative surgery (CS) of the supraglottic (SG) region. Data on patients treated with CS and postoperative radiotherapy (PORT)-IMRT were prospectively collected. Results. In total, 20 patients were analyzed. Of these, six patients (35%) required the positioning of a temporary tracheostomy. The functional larynx preservation rate was 95%. Females had a higher risk of both endoscopic intervention and chondronecrosis, while the median age was significantly higher in patients requiring enteral nutrition. The incidence of long-term severe toxicities was lower in patients treated with IMRT than in the historical 3D-CRT cohort. Patients who had received PORT-IMRT achieved a lower rate of permanent laryngeal and swallowing dysfunctions. Overall, results from the comparison with the historical 3D-CRT cohort favor the IMRTs.

Keywords: intensity-modulated radiotherapy; organ preservation; supraglottic region; toxicity.

Grants and funding

The IEO received an institutional research grant from Accuray Inc. and was also partially supported by the Italian Ministry of Health with Ricerca Corrente and 5 × 1000 funds. The sponsors did not play any role in the study design, collection, analysis and interpretation of data, nor in the writing of the manuscript, nor in the decision to submit the manuscript for publication.