title: Laryngeal preservation with induction chemotherapy for hypopharyngeal squamous cell carcinoma: 10-year results of EORTC trial 24891.
abstract: BACKGROUND
  We report the 10-year results of the EORTC trial 24891 comparing a larynx-preservation approach to immediate surgery in hypopharynx and lateral epilarynx squamous cell carcinoma.
  
  
  METHODS
  Two hundred and two patients were randomized to either the surgical approach (total laryngectomy with partial pharyngectomy and neck dissection, followed by irradiation) or to the chemotherapy arm up to three cycles of induction chemotherapy (cisplatin 100 mg/m(2) day 1 + 5-FU 1000 mg/m(2) day 1-5) followed for complete responders by irradiation and otherwise by conventional treatment. The end points were overall survival [OS, noninferiority: hazard ratio (preservation/surgery) ≤ 1.428, one-sided α = 0.05], progression-free survival (PFS) and survival with a functional larynx (SFL).
  
  
  RESULTS
  At a median follow-up of 10.5 years on 194 eligible patients, disease evolution was seen in 54 and 49 patients in the surgery and chemotherapy arm, respectively, and 81 and 83 patients had died. The 10-year OS rate was 13.8% in the surgery arm and 13.1% in the chemotherapy arm. The 10-year PFS rates were 8.5% and 10.8%, respectively. In the chemotherapy arm, the 10-year SFL rate was 8.7%.
  
  
  CONCLUSIONS
  This strategy did not compromise disease control or survival (that remained poor) and allowed more than half of the survivors to retain their larynx.
authors.affiliation: Head and Neck Cancer Department, Centre Oscar Lambret, Lille, France. Electronic address: jl-lefebvre@o-lambret.fr.
authors.forename: J-L
authors.initials: JL
authors.lastname: Lefebvre
authors.affiliation: Surgery Department, Institut Jules Bordet, Brussels, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Andry
authors.affiliation: Otolaryngology Department, Centre Hospitalier Régional Claude Huriez, Lille.
authors.forename: D
authors.initials: D
authors.lastname: Chevalier
authors.affiliation: Surgery Department, Institut Gustave Roussy, Villejuif, France.
authors.forename: B
authors.initials: B
authors.lastname: Luboinski
authors.affiliation: Statistics Department, EORTC Headquarters, Brussels, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Collette
authors.affiliation: Oto-Rhino-Laryngeology Department, Hôpital Pellegrin, Bordeaux.
authors.forename: L
authors.initials: L
authors.lastname: Traissac
authors.affiliation: Facial Surgery Department, Centre François Baclesse, Caen, France.
authors.forename: D
authors.initials: D
authors.lastname: de Raucourt
authors.affiliation: Department of radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Langendijk
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D007830:Larynx / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015996:Survival Rate