Beyond complete remission: A comparative analysis of long-term laryngeal function in patients with hypopharyngeal and laryngeal cancer following radiotherapy and concurrent chemoradiation

Head Neck. 2025 Feb;47(2):495-503. doi: 10.1002/hed.27935. Epub 2024 Sep 14.

Abstract

Background: This study evaluates functional larynx preservation in patients with hypopharyngeal cancer (HPC) and laryngeal cancer (LC) who achieved complete remission following radiotherapy (RT) or concurrent chemoradiation (CCRT).

Methods: HPC and LC patients treated with RT/CCRT from 1999 to 2017 were retrospectively analyzed. Severe late dysphagia and tracheostomy cases were assessed to determine laryngeal function. Long-term preservation rate of functional larynx and associated factors were evaluated.

Results: Of 152 patients (55 HPC, 97 LC), nine developed severe dysphagia, occurring on average 58.2 months post-treatment. HPC and cervical node metastasis significantly increased the risk of laryngeal function impairment (p < 0.001 and p = 0.014, respectively), presenting a continued decline in functional larynx preservation rate beyond 10 years.

Conclusions: Patients with HPC and cervical node metastasis demonstrate an increased risk for long-term laryngeal function impairment despite successful oncologic outcomes. This risk extends beyond 10 years, underscoring the need for prolonged monitoring and comprehensive support.

Keywords: concurrent chemoradiotherapy; dysphagia; hypopharyngeal cancer; laryngeal cancer; radiotherapy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chemoradiotherapy* / adverse effects
  • Deglutition Disorders / etiology
  • Female
  • Humans
  • Hypopharyngeal Neoplasms* / pathology
  • Hypopharyngeal Neoplasms* / therapy
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / therapy
  • Larynx / radiation effects
  • Male
  • Middle Aged
  • Organ Sparing Treatments
  • Remission Induction
  • Retrospective Studies