[Results of an organ conservation protocol in patients with locally advanced laryngeal tumours].
OBJECTIVE
Advanced laryngeal carcinoma patients, candidates for total laryngectomy, nowadays have different treatment options. One of them is induction chemotherapy, which allows modulation of the second manoeuvre according to the degree of response achieved. This study presents the results of a large series of patients treated according to this protocol.


METHODS
Retrospective study of 370 patients with T3-T4 carcinomas of the larynx considered as candidates for total laryngectomy. All patients were treated with the protocol mentioned above.


RESULTS
Seven patients died as a consequence of the treatment with chemotherapy. Among 363 patients finishing chemotherapy, 154 (43 %) achieved complete response and proceeded with radiotherapy. Total laryngectomy was performed in 135 (37 %) non-responders and 74 (20 %) patients were treated with radiotherapy in spite of an incomplete response to chemotherapy. Overall actuarial survival was 73 % at five years. Survival for patients with complete response and treated with radiotherapy was 77 % and for non-responders subjected to total laryngectomy it was 76 %. Non-responders treated with radiotherapy had a 5-year survival rate of 64 %, significantly different to both other groups (p = 0.01). Larynx preservation was achieved in 42 % of the patients, rising to 72 % for complete responders to chemotherapy and to 62 % in non-responders receiving radiotherapy.


CONCLUSIONS
Our larynx preservation protocol including induction chemotherapy for patients with advanced carcinomas who are candidates for total laryngectomy achieved a total survival rate of 73 % with a 42 % larynx preservation rate. The response to the induction chemotherapy was the factor contributing most to larynx preservation.
León
Xavier
X
Servicio de Otorrinolaringología, Hospital de Sant Pau, Barcelona, España. xleon@santpau.cat
López
Montserrat
M
García
Jacinto
J
Quer
Miquel
M
D000368:Aged; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate