Radiotherapy treats cancer by using high-energy beams to destroy cancer cells, while doing as little harm as possible to normal cells. How and when radiotherapy is used to treat cancer of the larynx depends on the stage of the cancer.

Radiotherapy for early-stage cancers

Radiotherapy can be used on its own if you have an early-stage laryngeal cancer. Sometimes doctors advise you to have radiotherapy when surgery is likely to affect your speech or swallowing.

Radiotherapy for locally advanced cancers

If the cancer is larger or has spread to lymph nodes (glands) or tissue nearby, you may have radiotherapy in combination with other treatments. Radiotherapy can be given:

• after surgery to destroy any remaining cancer cells and reduce the risk of cancer coming back (adjuvant radiotherapy)
• after surgery, together with chemotherapy (adjuvant chemoradiation)
• instead of surgery, together with chemotherapy (chemoradiation)
• with a targeted therapy drug.

The aim of radiotherapy for early and locally advanced cancer of the larynx is to cure the cancer. This is called radical radiotherapy.

Radiotherapy for advanced cancers

Sometimes it isn’t possible to cure the cancer and the main aim of treatment is to reduce the symptoms (palliative radiotherapy).

Radiotherapy can be used to shrink a tumour that is causing swallowing or breathing problems. It can also relieve symptoms if the cancer has spread to other parts of the body.

Treatment is usually given as a course of short, daily treatments in the hospital radiotherapy department. Each treatment is called a fraction. Radiotherapy can be given in different ways and you will usually have it as an outpatient. The treatments are normally given each day from Monday to Friday, with a rest at the weekend. However, sometimes you may also have treatment at the weekend, or more than one treatment each day – this is called hyperfractionation.

Radiotherapy treatment can last between 3 and 7 weeks. Your clinical oncologist will talk to you about the length of your course of treatment and possible side effects. If you’re having radiotherapy to relieve symptoms, you may only need a short course or a single dose.

Conformal radiotherapy (CRT)

This is one way of giving radiotherapy for early laryngeal cancers. A special attachment to the radiotherapy machine shapes the radiation beams to match the shape of the cancer. This reduces the radiation received by surrounding healthy cells.

Intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT)

These treatments are now available in most hospitals. IMRT accurately shapes the radiotherapy beams and allows different doses to be given to different parts of the treatment area. This can reduce the damage to healthy tissue. IGRT involves having images taken before each treatment. These are used to check that you are in exactly the right position for treatment. When possible, doctors use both IMRT and IGRT to treat locally advanced and advanced laryngeal cancer. These treatments can help reduce the risk of some long-term radiotherapy side effects, such as damage to the salivary glands, which causes a dry mouth.