Larynx Cancer

Andrew Okhuereigbe

General Patient Information

Patient is a 61-year-old gentleman who noticed
hoarseness in the fall of last year.
The patient's medical history includes hepatomegaly
with subclinical liver disease.
The patient had surgery on his left arm in 1990.
The patient has no radiation therapy or
chemotherapy history.
The patient was diagnosed with hypertension in July
2013 and diagnosed with subclinical liver disease
due to daily alcohol consumption in March 2014.
Patients medications include losartan/potassium
100 mg and amlodipine 2.5 mg

Social and Family History

Patient drinks 3 to 4 drinks per day and smokes
half a pack of cigarettes daily.
Patient lives by himself. He is a police officer for
the printing and engraving department.
Patients father died of cancer.
His mother is deceased related to complications
of diabetes mellitus and hypertension

Diagnostic Clinical Detection

In February 2014, a biopsy showed a left true
vocal cord lesion with well moderately
differentiated squamous cell carcinoma
Diagnosis is T1aN0M0 well moderately
differentiated squamous cell carcinoma of the
glottis.

Adjuvant Therapy
The patient is a candidate for surgery but
radiation treatment is treatment of choice
because it is an early stage glottis cancer.

Dose, fractionation scheme, etc

The patient was planned for the ALPHA linear
accelerator using 3D conformal imaging.
The patients treatment site is his larynx.
He is being given a planned does of 200 cGy in
33 fractions daily equaling a total dose of 6600
cGy.
His plan included 2 treatment fields: Rt. Lat and
Lt. Lat.

Planning Simulation/Localization
Procedures
The patient was positioned head first supine on
the table.
An orfit facemask was used to immobilize and
easily reproduce the patients position.
The patients arms were by his sides and t straps
were used.
A sponge was placed underneath the patients
knees.
AP setup tattoos were used to ensure the
patients position was straight

Field Borders
The superior border: the upper thyroid notch.
The inferior border: the cricoid cartilage.
The anterior border includes a 1 to 1.5 cm shine
over (flash) over the skin surface at the level of
the vocal cords.
The posterior border: just anterior to the
vertebral body.
Glottis legions are not aggressive and cervical
lymph node involvement is not present.

Treatment Unit Information

Actual SSD
(cm)

Field Name

Machine

Energy

Gantry
Angle

Collimator
Angle

Couch
Angle

Planned
SSD (cm)

RT. LAT

ALPHA

10X

270

84

93.7

93.7

LT. LAT

ALPHA

10X

90

96

94.4

94.3

Organs At Risk
Special Organs in Head and Neck Region

TD 5/5 (cGy)

ORAL CAVITY

6000

SPINAL CORD

4500

LENS OF EYE

500

BRAIN

6000

RETINA

5500

CORNEA

5000

EAR

5000

Radiation Side Effects

temporary fatigue
skin changes
sore throat
difficulty swallowing
dry mouth
thick saliva
voice changes
loss of appetite
and loss of taste

Citation
Leaver, D., & Washington, C.(2009).Head and
Neck Cancers :Principles and Practice of
Radiation Therapy, 730.