A recurrent Subglottis carcinoma treated successfully with TrueBeam LINAC

B. Sathish

Consultant Radiation Oncologist, Kauvery Hospital, Tennur, Trichy, Tamil Nadu

Case presentation

A 53-year-old male with carcinoma of the glottis/subglottis underwent total laryngectomy in Aug 2024 and presented in May 2025 with an inoperable stomal recurrence (5.5 × 4.0 × 2.7 cm, SUV 20.2).

He was taken up for salvage chemo-radiation using RapidArc – our first such case on this machine – and completed 50 Gy in 25 fractions with weekly cisplatin on 31 Jul 2025 (dose escalation was limited by esophageal tolerance).

Midway, the tumor showed dramatic shrinkage, and we performed adaptive replanning (re-simulation and re-contouring) – a demanding, labor-intensive step not commonly done in many centers, but crucial here to maintain precision. The patient tolerated treatment well, with only grade 2 toxicity and minimal skin reaction, completing therapy with excellent compliance.

His PET-CT on 12 Sep 2025 now shows complete metabolic response, with no FDG-avid residual disease.

Conclusion

This case is special as it was our very first on the new LINAC, but more importantly it demonstrates how precision radiation and adaptive techniques can achieve meaningful outcomes with good tolerance, even in complex, recurrent, previously treated inoperable cancers. Since then, we have treated close to 80 patients so far with the same philosophy of precision care, and we look forward to many more such results for the other cases that we have treated.

Kauverian Bookshelf

Applied Medical Statistics

Journals

Kauvery Hospital
Find Doctor
Book Appointment