title: Randomized phase III trial comparing induction chemotherapy followed by radiotherapy to concomitant chemoradiotherapy for laryngeal preservation in T3M0 pyriform sinus carcinoma.
abstract: CONCLUSIONS
  Conventional radiotherapy with concurrent cisplatin is significantly superior to induction cisplatin fluorouracil chemotherapy followed by radiotherapy in terms of laryngeal preservation in patients with T3 hypopharyngeal carcinoma. Despite a high rate of laryngeal preservation no survival benefit was recorded in this selected population.
  
  
  OBJECTIVE
  To compare conventional radiotherapy with concurrent cisplatin to induction chemotherapy with cisplatin fluorouracil followed by conventional radiotherapy. The primary end point was the preservation of the larynx. The secondary end points included toxicity, causes of death, and survival rates.
  
  
  METHODS
  Seventy-one adult patients with previously untreated resectable T3 pyriform sinus squamous cell carcinoma were enrolled in the multicenter prospective randomized phase III trial. They were evaluated for organ preservation, survival rates, and toxic reactions.
  
  
  RESULTS
  The rates of laryngeal preservation at 2 years were 68% for the induction chemotherapy (IC) group and 92% for the chemoradiotherapy (CR) group (p = 0.016). At 2 years, the event-free survival rates were 36% and 41% for the IC group and CR group, respectively.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Saint-Etienne University Hospital Center, Loire Cancer Institute, Saint-Etienne, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Prades
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lallemant
authors.forename: Renaud
authors.initials: R
authors.lastname: Garrel
authors.forename: Emile
authors.initials: E
authors.lastname: Reyt
authors.forename: Christian
authors.initials: C
authors.lastname: Righini
authors.forename: Thierry
authors.initials: T
authors.lastname: Schmitt
authors.forename: Nagib
authors.initials: N
authors.lastname: Remini
authors.forename: Lea
authors.initials: L
authors.lastname: Saban-Roche
authors.forename: Andrei P
authors.initials: AP
authors.lastname: Timoshenko
authors.forename: Beatrice
authors.initials: B
authors.lastname: Trombert
authors.forename: Bernard
authors.initials: B
authors.lastname: Guerrier
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002423:Cause of Death; D002945:Cisplatin / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D007825:Laryngectomy; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D056144:Pyriform Sinus
chemical_list: D002945:Cisplatin; D005472:Fluorouracil