Radiotherapy reduces need for surgery in patients with laryngeal amyloidosis

Recently, use of radiotherapy (RT), either alone or postoperatively, for LA has been adapted and it is observed that RT after surgery for LA can provide good local control without unacceptable toxicity, reports a study published in The Laryngoscope.

Laryngeal amyloidosis (LA) is a rare disease characterized by extracellular protein deposition within the larynx. Treatment of laryngeal amyloidosis (LA) is difficult due to the frequently submucosal and multifocal nature of disease. Caitlin Bertelsen and colleagues from the Department of Otolaryngology/Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A. described the experience with adjuvant RT for LA at their center.

A retrospective series of cases with amyloidosis of the larynx, with or without other disease sites, seen at a tertiary academic center were included for the study. Outcomes included disease characteristics, recurrence rates, treatment modalities, and pre- and posttreatment voice handicap index (VHI)-10.

The authors observed that ten patients met eligibility criteria. The mean follow-up time for all patients was 62.0 ± 41.0 months; mean follow-up time after last treatment was 51 ± 55 months.

All but one patient underwent surgical resection of disease. Seven patients underwent subsequent RT. Of these seven, six underwent RT at our institution; five received a dose of 45 Gray (Gy); and one received a dose of 20 Gy.

All seven completed RT without toxicity-related interruption. Patients undergoing RT underwent 2.1 ± 1.3 surgical procedures prior to RT; no patients required surgery after RT. Mean pretreatment VHI-10 was 22.9 ± 8.1; mean posttreatment VHI-10 was 12.9 ± 13.3.

Therefore, this led the authors to conclude that RT after surgery for LA can provide good local control without unacceptable toxicity and may decrease the need for further surgery.