Late-Onset Radiation-induced Morphologic Change and Functional Disorder in Larynx

Abstract

The objective of our study was to determine the risk factors of late-onset radiation induced morphologic change and function disorder in larynx. Six cases of late-onset laryngeal necrosis and fibrosis after radiotherapy for head and neck cancers between 1994 and 2008 were evaluated. All of the patients were male with ages ranging from 57 to 74 years. The cases included three with supraglottic laryngeal cancer (T2), two with glottic laryngeal cancer (T1a), and one with an unknown origin metastatic neck tumor. Radiation injury was found from as early as 4 months up to 77 months after radiotherapy. Laryngeal late-onset radiation-induced Morphologic change and functional disorder were observed in patients having had supraglottic laryngeal cancer (T2), concurrent chemoradiotherapy, LASER surgery, or an over exposure dose. Consequently these patients were thought to be at risk for delayed radiation-induced sequelae. While almost all laryngeal necrosis was found within 6 months, supra-laryngeal fibrous stenosis was observed even beyond 24 months. It was difficult to discriminate between i Laryngeal necrosis and recurrent cancer, as well as to determine an early diagnosis of supra-laryngeal fibrous stenosis. It is, Therefore, essential that patients with risk factor of late-onset radiation-induced sequelae be followed up over the long-term.