Early results of radiotherapy for advanced laryngeal cancer using three small fractions per day

Fifteen patients with stage III or IV squamous cell carcinoma of the larynx were treated by primary radiotherapy using a schedule of 3 small (1.1-1.5 Gy) fractions per day, an interval between fractions of 3-4 h, and a total dose of approximately 60 Gy. Primary tumour control was achieved in 13 cases, but in one of these neck node metastases were not controlled. Acute mucosal reactions were brisk, but tolerable; late complications were severe in 3 patients. Early, encouraging results in terms of tumour response must be tempered by caution over the late damage: a number of factors probably contribute to this, especially interval between fractions and total dose. From a practical viewpoint, the latter may be easier to influence, if 3 small fractions per day are to continue to be used.