title: Clinical predictors of larynx preservation after multiagent concurrent chemoradiotherapy.
abstract: BACKGROUND
  Determining which patients benefit from larynx preservation strategies remains problematic. We reviewed our experience using multiagent concurrent chemoradiotherapy to identify clinical predictors for success.
  
  
  METHODS
  Cisplatin and fluorouracil were given during weeks 1 and 4 of radiation to 115 patients with locoregionally advanced larynx or hypopharynx squamous cell cancer without cartilage invasion or laryngeal destruction. Laryngectomy was reserved for local failure.
  
  
  RESULTS
  The 5-year Kaplan-Meier projected overall survival was 58%, survival with larynx preservation 52%, local control without surgery 82%, local control (including surgical salvage) 94%, and survival with functional larynx 49%. Local control without surgery was superior in patients with T1-2 versus T3-4 tumors (97% vs 77%, p = .032). No other clinical parameters proved predictive of local control.
  
  
  CONCLUSIONS
  Larynx preservation was successful in all subsets of appropriately selected patients. Although local failure was more likely in patients with T3-4 tumors, it was infrequent and surgical salvage was effective.
authors.affiliation: Cleveland Clinic, Taussig Cancer Center, Cleveland, Ohio, USA. rodrigc@ccf.org
authors.forename: Cristina P
authors.initials: CP
authors.lastname: Rodriguez
authors.forename: David J
authors.initials: DJ
authors.lastname: Adelstein
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Rybicki
authors.forename: Jerrold P
authors.initials: JP
authors.lastname: Saxton
authors.forename: Robert R
authors.initials: RR
authors.lastname: Lorenz
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Wood
authors.forename: Marshall
authors.initials: M
authors.lastname: Strome
authors.forename: Ramon M
authors.initials: RM
authors.lastname: Esclamado
authors.forename: Pierre
authors.initials: P
authors.lastname: Lavertu
authors.forename: Marjorie A
authors.initials: MA
authors.lastname: Carroll
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D010358:Patient Participation; D018579:Patient Selection; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil