It's always the same with the boss fights in TW1-3, OP: They seem to be challenging as long as you don't know how to manage them. But if you find the king's way (or the king's ways) the boss fights get easy enough. They are some kind of riddle.
Letho has unpleasant ranged attacks. So Geralt has to prevent Letho from using them. He should be aggressive, then Letho has limited ressources.
As soon as you get control after the cutscene, Geralt should cast Aard
immediately to prevent Letho from casting Quen - and then don't let get him off the hook.
Don't know your difficulty level: If your DL is "normal" then you should be able to control Letho completely with Aard:
https://www.youtube.com/watch?v=juMEEvPQ9Rs The king's way is "Yrden" - if you prefer short bossfights. If Letho has only 40 -45% of his LPs the fight is over - but not the dialogue. When Geralt says: "You should have surrendered when you could" he should stop fighting and get into safety until the cutscene begins.
Then you finish the fight in less than half a minute, even in dark mode:
https://www.youtube.com/watch?v=S1z-RAPuYMc And what's to do if really nothing helps? Then switch to "easy" for this fight. Letho mutates to a tinker, uncapable to do anything right but talking - long-winded. He's completely helpless, he can't block at all. After 8 - 10 hard strokes the fight is over, then you have to wait again:
https://www.youtube.com/watch?v=G_hLsP9jsU8