Chemotherapy alone for organ preservation in advanced laryngeal cancer.
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.


CONCLUSIONS
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.
Divi
Vasu
V
Department of Otolaryngology-Head and Neck Surgery, Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA.
Worden
Francis P
FP
Prince
Mark E
ME
Eisbruch
Avraham
A
Lee
Julia S
JS
Bradford
Carol R
CR
Chepeha
Douglas B
DB
Teknos
Theodoros N
TN
Hogikyan
Norman D
ND
Moyer
Jeffrey S
JS
Tsien
Christina I
CI
Urba
Susan G
SG
Wolf
Gregory T
GT
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016190:Carboplatin; D002945:Cisplatin; D005472:Fluorouracil