Chemoradiotherapy for laryngeal cancer

Treatment with chemotherapy and radiotherapy together is called chemoradiotherapy.

Chemotherapy uses anti cancer drugs to destroy cancer cells. These drugs are also called cytotoxic drugs Open a glossary item. The drugs circulate throughout the body in the bloodstream.

Radiotherapy uses radiation, usually x-rays, to destroy cancer cells.

Having the two treatments together often works better than having them on their own.

When you might have chemoradiotherapy for laryngeal cancer

You might have chemoradiotherapy:

  • on its own as your main treatment for locally advanced Open a glossary item laryngeal cancer instead of surgery. An advantage of chemoradiotherapy in this situation is that you might still be able to speak afterwards. But you might need surgery if there are still signs of cancer after chemoradiotherapy
  • after surgery to reduce the risk of the cancer coming back 
  • if the cancer cannot be removed by surgery

Chemoradiotherapy can be difficult to cope with. The side effects are the same kinds of side effects you can get from radiotherapy or chemotherapy alone. But when you have both treatments together some can be more severe.

You will have tests to find out if you are fit enough to have chemoradiotherapy. If you aren't you might be able to have surgery to remove the cancer followed by radiotherapy.

Your doctors consider many things when they plan your treatment. They will explain what treatment you are having and how long you have it for. They will also go through all the possible side effects. 

Types of chemotherapy

When you have chemoradiotherapy, you might have any of these chemotherapy drugs:

  • cisplatin

  • carboplatin

  • fluorouracil (5FU)

Check what the name of your regimen is with your doctor or nurse, then take a look at our A to Z list of cancer drugs.

How you have chemotherapy

You have chemotherapy through a drip (an infusion). Your nurse puts a small tube into one of your veins and connects it to the drip, or you might need a central line. This is a long plastic tube that gives the drug into a large vein, either in your chest or in your arm. The tube stays in while you’re having treatment, which might be for a few months.

You might also have some of these treatments as part of a clinical trial.

Where you have chemotherapy

You usually have treatment in the chemotherapy day unit or you might need to stay in hospital for a day or more.

Having radiotherapy

Planning your treatment

Before you begin treatment, the radiotherapy team works out how much radiation you need. They divide it into a number of smaller treatments. They call each treatment a fraction.

You have a mask made before you start radiotherapy.

Having treatment

It can take a few days or up to 3 weeks before you start treatment.

You lie under a large machine to have radiotherapy.

Tests

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

Treatment cycles

You take some cancer medicines in treatment cycles. This means you take the drug for a set period, followed by a break. For example, you might take a drug every day for a week and then not take it for 2 weeks. This 3 week period in total is one cycle of treatment.

Take your cancer drugs exactly as your doctor, specialist nurse or pharmacist has told you to. The break from treatment is important too. For many cancer drugs, it allows your body to recover.

Side effects of chemoradiotherapy

Most people will have side effects from chemoradiotherapy for laryngeal cancer. Combining chemotherapy and radiotherapy can make side effects worse. But everyone is different and the side effects vary from person to person. You might not have all the side effects mentioned. 

Side effects depend on:

  • how well you are before treatment
  • which chemotherapy drugs you have
  • how much of each drug you have
  • the dose of radiotherapy
  • how long you have your radiotherapy treatment for

Chemotherapy side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • increased risk of getting an infection
  • bleeding and bruising easily
  • diarrhoea and constipation
  • hair loss

Contact your doctor or nurse if any of the side effects are severe. Or contact them if your temperature goes above 37.5°C or below 36°C. Infections can make you very unwell very quickly.

Radiotherapy side effects

Common radiotherapy side effects include:

  • a sore mouth and throat
  • feeling very tired
  • difficulty swallowing
  • feeling or being sick
  • voice changes
  • reddening or darkening of the skin in the area you have your radiotherapy 

Smoking

If you smoke, your doctor will advise you to stop. Smoking during treatment can make the side effects much worse. 

  • Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth edition
    J Homer and S C Winter
    The Journal of Laryngology & Otology, 2024. Volume 138, Number S1

  • Improving outcomes in head and neck cancer 
    The National Institute for Health and Care Excellence (NICE), November 2004 (guidelines checked June 2015)

  • Laryngeal cancer - BMJ Best Practice

    Matthew Pierce.

    Last reviewed: 24 Apr 2024 Last updated: 16 Apr 2024 (accessed August 2024)

  • Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS- ESMO -ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up

    J P  Machiels and others

    Annals of Oncology, 2020. Volume 31, Issue 11

Last reviewed: 
27 Aug 2024
Next review due: 
27 Aug 2027

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