Author(s)
Alexandra Filipkowski BS1, MPH
Joseph Celidonio BS1
Nicholas Hamilton BS1
Raj Malhotra BS1
Samantha Shave BS2
Dr. Kenneth Yan MD, PhD1
Dr. Rachel Kaye MD, FACS1
Affiliation(s)
Rutgers New Jersey Medical School, Newark, New Jersey, USA. 2Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA;
Abstract:
Background: Laryngeal chondroradionecrosis (LCRN) is a rare but significant complication of radiation therapy for laryngeal cancer treatment. LCRN poses diagnostic challenges as common symptoms such as pain, dyspnea, dysphagia, and dysphonia can also be present with tumor persistence or recurrence. There is currently no accepted algorithm for LCRN diagnosis as literature is sparse. The purpose of this study is to provide a comprehensive review of available LCRN literature, focusing on patient characteristics, tumor parameters, radiation dose, and patient outcomes.
Methods: PubMed, Embase, and Web of Science were searched from inception until September 2024. Studies with original LCRN data from the past decade were included. Data on demographics, symptoms, and treatment were collected.
Results: Of the 86 patients included, 85.1% were male, mean age was 56.9 years, and 88.3% were Chandler classification IV. 80.0% of patients received a radiation dose =67.5 Gray (Gy) while 20.0% received <67.5 Gy. 17.8% of patients received a tracheostomy, 51.1% underwent laryngectomy, and 8.9% expired. Comparing high vs. low radiation dose (>67.5 vs <67.5 Gy), there was no significant difference in symptomatic improvement without a persistent tracheostomy or stoma (40.6% vs. 12.5%, p = 0.136), need for persistent tracheostomy (11.8% vs. 50.0%, p = 0.298), persistent stoma (51.6% vs. 87.5%, p = 0.109), laryngectomy (46.9% vs. 75.0%, p = 0.154), or mortality (9.4% vs. 0%, p = 0.368).
Conclusions: In our cohort, the majority of LCRN patients required surgical intervention. Radiation dose was not associated with a difference in patient outcomes.