Your gift is 100% tax deductible.
Radiation Therapy for Laryngeal and Hypopharyngeal Cancer
Radiation therapy might be used as the main treatment for laryngeal or hypopharyngeal cancer, or it might be used in combination with other treatments. It may also be used to help with symptoms. When and how it is used depends on the stage of the cancer and other factors.
Radiation therapy is the use of high-energy x-rays or particles to destroy cancer cells or slow their growth.
These cancers are located near many critical structures in your head and neck. It’s very important to go to a cancer center that has experience treating them.
When is radiation therapy used to treat laryngeal and hypopharyngeal cancers?
Depending on the stage of the laryngeal or hypopharyngeal cancer and other factors, radiation therapy might be used:
- As the main treatment for some early-stage cancers. A small cancer can often be destroyed by radiation, and surgery is not needed. This can help preserve voice quality.
- After surgery (adjuvant therapy) to try to kill any small areas of cancer that might have been left behind because they were too small to see with the naked eye. This can also help lower the chance the cancer will come back.
- To help with symptoms of advanced cancer, such as pain, bleeding, or trouble swallowing.
- To treat cancer recurrence (cancer that comes back after treatment).
For advanced laryngeal and hypopharyngeal cancers, chemotherapy is often given at the same time as radiation. This combination is called chemoradiation. It often works better than radiation alone, but it also has more side effects.
What type of radiation therapy is used?
External beam radiation therapy is the most common type of radiation used to treat laryngeal and hypopharyngeal cancers.
Intraoperative radiation therapy (IORT) and brachytherapy may also be used in some situations.
External beam radiation (EBRT)
EBRT uses x-rays aimed at the tumor from a large machine outside your body.
Radiation therapy is a lot like getting an x-ray, but the radiation dose is stronger and aimed more precisely at the cancer. The treatment does not hurt and the machine doesn't touch you. Each treatment lasts only a few minutes, but it often takes longer to set up and get you in place for each treatment.
Before you start EBRT, a somewhat flexible but sturdy mesh head and neck mask might be made. This will help hold your head, neck, and shoulders in the exact same position for each treatment. Some people feel a bit confined while this mask is on and might need to ask for medicine to help them relax during the treatment.
The mask can sometimes be adjusted so it’s less constricting. Discuss your options with your radiation oncologist. You might also be fitted for a bite block that you will hold in your mouth during treatment.
Common treatment schedules for EBRT
Standard EBRT for laryngeal or hypopharyngeal cancers is usually given in daily doses 5 days a week for about 7 weeks. Each dose is called a fraction.
Sometimes, other schedules might be used:
- Hyperfractionation radiation is a slightly lower radiation dose given more than once a day. For example, it might be given twice a day for 7 weeks.
- Accelerated fractionation radiation is the standard dose of radiation given each day but over a shorter time (5 to 6 weeks) instead of the usual 7 weeks. For example, radiation might be given 6 days a week over 5 weeks instead of the standard 5 days a week for 7 weeks.
- Hypofractionation radiation is a slightly higher radiation dose given each day to lessen the number of treatments. For example, a higher radiation dose might be given each day for 6 weeks, not the standard 7 weeks.
Hyperfractionation and accelerated fractionation schedules may reduce the risk of cancer coming back in or near the place it started (local recurrence). They might also help some people live longer compared to standard EBRT. The drawback is that these treatment schedules also tend to have more severe side effects.
Types of EBRT used for laryngeal and hypopharyngeal cancers
Several advanced EBRT techniques help doctors focus the radiation more precisely. Intensity-modulated radiation therapy (IMRT) is the most common of these techniques used to treat laryngeal and hypopharyngeal cancers.
IMRT uses a computer-controlled machine that moves around your body to send radiation from many directions. The shape and strength of the radiation beams can be adjusted to focus on the tumor while limiting radiation to nearby healthy tissues. This allows doctors to give a higher dose of radiation to the cancer while reducing side effects.
IMRT is often used with image-guided radiation therapy (IGRT). With IGRT, imaging tests such as x-rays or CT scans are done right before or during each treatment to help make sure the radiation is aimed exactly at the tumor. This helps account for small changes in body position or tumor location and improves the accuracy of the treatment.
Volumetric modulated arc therapy (VMAT)
VMAT is a more advanced form of IMRT. The machine moves in a continuous circle around your body while giving radiation. At the same time, the beam strength and shape are constantly adjusted. This makes treatment faster, more accurate, and more comfortable.
PBT focuses proton beams on the cancer. Radiation from a proton beam is not the same as radiation from an x-ray. X-rays go through your body and release radiation both before and after they hit the tumor. But protons only travel a certain distance, so the tissues behind the tumor may be exposed to less radiation. This is hoped to lessen side effects compared to other types of radiation.
SBRT may be used in certain cases, especially when the cancer comes back after earlier treatment. It works best for people with small tumors and no skin involvement.
SBRT uses special imaging and computer guidance to aim strong radiation directly at the tumor while protecting nearby healthy tissues such as the brain, eyes, and nerves. It is usually given in only a few sessions instead of many weeks. SBRT can be a helpful option for carefully selected patients.
Intraoperative radiation therapy (IORT)
In rare cases, intraoperative radiation therapy (IORT) may be used to treat laryngeal and hypopharyngeal cancers. This is usually done at large hospitals with special experience.
IORT is given during surgery. First, the doctor removes as much of the tumor as possible. Then a strong, focused dose of radiation is delivered directly to the area where the cancer was removed. This treatment might be followed by regular external radiation to help kill any remaining cancer cells.
Doctors carefully choose who can get this treatment. It works best for people who are in good overall health, had radiation more than 2 years ago, had surgery to remove most of the cancer first, and do not have major organ problems, such as needing a feeding tube or having serious breathing or swallowing issues.
This treatment is complex, so it is only used in special cases and for carefully selected patients.
Brachytherapy
Brachytherapy is another way to deliver radiation. You might also hear this called internal radiation. For this type of radiation therapy, very thin metal rods or wires are placed in or very near the cancer. These rods carry small pellets of radioactive materials. The radiation travels a very short distance, so it destroys the cancer without causing much harm to nearby healthy tissues.
Brachytherapy is not often used as a first treatment for laryngeal or hypopharyngeal neck cancers. It might be used if the cancer comes back after initial treatment. Sometimes, internal and external beam radiation therapy are used together.
Seeing a dentist before radiation treatment
Radiation to this part of your body can cause problems for your teeth and gums. Before you start treatment, it's important to see a dentist to make sure your mouth is healthy.
The dentist might recommend removing certain bad teeth before you start radiation because they can increase your chance of infection. The dentist will probably also recommend using some form of fluoride treatment after completing radiation.
Your dentist can help check for problems during and after treatment. They can address anything that comes up, such as infection or tooth and bone damage.
Possible side effects
Before you begin radiation therapy, it’s important to ask your cancer care team about the possible side effects so you know what to expect.
Common short-term side effects
Radiation to the mouth and throat area can cause several short-term side effects. This will depend on where the radiation is aimed. It could include:
- Skin changes like a sunburn or suntan in the treated area
- Hoarseness
- Loss of taste
- Redness, soreness, or pain in the mouth and throat
- Dry mouth
- Trouble swallowing
- Fatigue (extreme tiredness)
- Open sores in the mouth and throat
Long-lasting or permanent side effects
Some side effects might not get better over time, such as:
Many people treated with radiation to the throat area have painful sores in the mouth and throat. These sores can make it very hard to eat and drink. This can lead to weight loss and poor nutrition.
The sores heal with time after the radiation ends, but some people continue to have problems swallowing long after treatment ends because of the tightening of the muscles caused by radiation.
Ask your speech pathologist about swallowing exercises you can do to help keep those muscles working and increase your chance of eating normally after treatment.
You might need liquid feeding through a tube placed into your stomach. See Surgery for Laryngeal and Hypopharyngeal Cancer for more on feeding tubes.
Damage to the salivary (spit) glands from radiation can cause a dry mouth that does not get better with time. This can lead to discomfort and problems eating and swallowing, as well as damage to the jawbone.
The lack of saliva can also lead to tooth decay (cavities). To help prevent dental problems, people treated with radiation to the mouth or neck need to practice careful oral hygiene and see the dentist regularly. Fluoride treatments may also help.
This can be a serious side effect of radiation treatment. It is more common after tooth infection, extraction, or trauma, and it can be hard to treat. The main symptom is pain in the jaw. In some cases, the bone breaks. Sometimes the fractured bone heals by itself, but the damaged bone often has to be repaired with surgery.
To help prevent this problem, people getting radiation to the mouth or throat area need to see a dentist before starting treatment. The dentist can treat any problems with the teeth and remove teeth if needed.
Radiation might damage your thyroid gland. Your healthcare team will do blood tests regularly to see how well your thyroid is working. You might need treatment if it's been damaged and is not working well.
Some people might be at risk of developing lymphedema in the areas that were treated with radiation therapy. These areas can become swollen and firm. This can be worse if you also had surgery. Medicines, physical therapy, or massage therapy might sometimes be helpful.
These major blood vessels in your neck carry blood to your brain. They can sometimes become narrower after radiation. This could raise the risk of stroke or other problems, but it usually takes several years to occur.
More information about radiation therapy
To learn more about how radiation is used to treat cancer, see Radiation Therapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
- Written by
- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Dogan N, King S, Emami B, et al. Assessment of different IMRT boost delivery methods on target coverage and normal-tissue sparing. Int J Radiat Oncol Biol Phys 2003;57:1480-1491.
Mohamad I, Karam I, El-Sehemy A, et al. The Evolving Role of Stereotactic Body Radiation Therapy for Head and Neck Cancer: Where Do We Stand? Cancers (Basel) 2023;15:5010.
National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. Version 1.2026 – December 08, 2025. Accessed at www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf on February 20, 2026.
Romesser PB, Cahlon O, Scher ED, et al. Proton beam reirradiation for recurrent head and neck cancer: multi-institutional report on feasibility and early outcomes. Int J Radiat Oncol Biol Phys 2016;95:386-395.
Zhu B, Kou C, Bai W, et al. Accelerated Hyperfractionated Radiotherapy versus Conventional Fractionation Radiotherapy for Head and Neck Cancer: A Meta-Analysis of Randomized Controlled Trials. J Oncol. 2019;2019:7634746. Published 2019 Nov 28. doi:10.1155/2019/7634746.
Last Revised: May 28, 2026
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
American Cancer Society Emails
Sign up to stay up-to-date with news, valuable information, and ways to get involved with the American Cancer Society.