title: Induction chemotherapy in locally advanced pharyngolaryngeal cancers with stridor: is it feasible and safe?
abstract: Background. The standard initial management of patients with locally advanced pharyngolaryngeal presenting with stridor is tracheostomy. Tracheostomy has been shown to negatively impact cancer-related outcomes. Methods. Retrospective analysis of prospectively collected data of 9 patients, who underwent induction chemotherapy with the aim of prevention of tracheostomy. Presenting features, time to resolution of stridor, and further management are reported. Results. Eight out of 9 patient received chemotherapy within 12 hours of presentation with stridor. There were 4 patients each with primary hypopharynx and larynx. The stage was IVA in 6 patients and IVB in 2 patients. In all patients receiving immediate chemotherapy, clinical stridor resolved within 48 hours. The radiological response rate was 62.5%. The median reduction in size of tumor was 37%. Conclusion. Immediate neoadjuvant chemotherapy is a feasible and safe option for patients presenting with early stridor and helps in resolution of stridor and avoiding tracheostomy.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India.
authors.forename: Vijay Maruti
authors.initials: VM
authors.lastname: Patil
authors.forename: Vanita
authors.initials: V
authors.lastname: Noronha
authors.forename: Amit
authors.initials: A
authors.lastname: Joshi
authors.forename: Vamshi
authors.initials: V
authors.lastname: Muddu
authors.forename: Bhavesh
authors.initials: B
authors.lastname: Poladia
authors.forename: Bharat
authors.initials: B
authors.lastname: Chauhan
authors.forename: Kumar
authors.initials: K
authors.lastname: Prabhash
authors.forename: Devendra Arvind
authors.initials: DA
authors.lastname: Chaukar
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chatturvedi
authors.forename: Gouri
authors.initials: G
authors.lastname: Pantvaidya
authors.forename: Shashikant
authors.initials: S
authors.lastname: Juvekar
authors.forename: Anil
authors.initials: A
authors.lastname: D'cruz