Overview of glottic laryngeal cancer treatment recommendation changes in the NCCN guidelines from 2011 to 2022

Clinical Outcomes of Curative Intent Radiotherapy by Helical Tomotherapy for Laryngeal Squamous Cell Carcinoma: A Retrospective Analysis in a Tertiary Referral Center

Background

The management of laryngeal cancer involves balancing curative treatment with preserving essential functions. This study aimed to evaluate the clinical outcomes of helical tomotherapy, an advanced form of radiation therapy, as a primary treatment modality for laryngeal squamous cell carcinoma (LSCC).

Methods

A retrospective analysis of data obtained from a tertiary referral center was performed to assess treatment response rates, survival outcomes, disease control, and treatment-related adverse events.

Results

The study included 45 patients with LSCC treated with helical tomotherapy between May 2015 and September 2022. The 5-year overall survival (OS) rate and disease-free survival (DFS) rate were 89.2% and 71.1%, respectively. Local control and laryngeal preservation rates at 5 years were 79.7% and 84.7%, respectively. Subgroup analysis revealed higher DFS rates in early-stage patients (84.2%) compared to advanced-stage patients (58.9%).

Conclusions

The results indicate that helical tomotherapy offers effective tumor control and potential for laryngeal preservation in LSCC. Further prospective studies and longer follow-up are needed to validate these findings and optimize treatment strategies for LSCC patients.

Rare Direct Locoregional Brain Metastasis and Recurrence in Laryngeal Squamous Cell Carcinoma

Laryngeal cancer is predominantly a squamous cell in origin that can present with voice changes and difficulty or pain with swallowing. It is more likely to cause local spread than distant ones. The prognosis depends on multiple factors, including the stage, tumor differentiation, extranodal extension, and adjuvant therapy. Head and neck cancers have a higher tendency for perineural invasion and spread, one of the most vital factors correlating with poor outcomes and recurrence rates. We present a rare case of a 52-year-old male with an extensive history of tobacco use (five packs per day over 30 years) who developed laryngeal squamous cell carcinoma that spread to the brain despite total laryngectomy and adjuvant radiation therapy. Despite resection of the brain metastasis, the tumor metastasized again in the brain through perineural spread. Due to the side effects of repeated radiotherapy and starting chemotherapy, the patient opted for comfort care and refused further treatment. The perineural spread of head and neck cancers is not abundant in the literature, and we believe our case will add to the future treatment of head and neck cancers with perineural invasion.