Chemotherapy alone for organ preservation in advanced laryngeal cancer

Head Neck. 2010 Aug;32(8):1040-7. doi: 10.1002/hed.21285.

Abstract

Background: For patients with advanced laryngeal cancer, a trial was designed to determine if chemotherapy alone, in patients achieving a complete histologic complete response after a single neoadjuvant cycle, was an effective treatment with less morbidity than concurrent chemoradiotherapy.

Methods: Thirty-two patients with advanced laryngeal or hypopharyngeal cancer received 1 cycle of induction chemotherapy, and subsequent treatment was decided based on response.

Results: A histologic complete response was achieved in 4 patients and were treated with chemotherapy alone. All 4 patients' cancer relapsed in the neck and required surgery and postoperative radiotherapy (RT). Twenty-five patients were treated with concomitant chemoradiation. Three patients were treated with surgery. Overall survival and disease-specific survival at 3 years were 68% and 78%, respectively.

Conclusion: Chemotherapy alone is not feasible for long-term control of regional disease in patients with advanced laryngeal cancer even when they achieve a histologic complete response at the primary site.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Carboplatin / therapeutic use
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Cisplatin / therapeutic use
  • Combined Modality Therapy
  • Female
  • Fluorouracil / therapeutic use
  • Follow-Up Studies
  • Humans
  • Hypopharyngeal Neoplasms / drug therapy*
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / surgery
  • Laryngeal Neoplasms / drug therapy*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Carboplatin
  • Cisplatin
  • Fluorouracil