title: Selection of therapeutic treatment with alternating chemoradiotherapy for larynx preservation in laryngeal carcinoma patients.
abstract: OBJECTIVE
  We analyzed the efficacy of treatments that included alternating chemoradiotherapy in laryngeal cancer patients.
  
  
  METHODS
  Alternating chemoradiotherapy consisted of chemotherapy with 5-fluorouracil (600 mg/m(2)/day) on Days 1-6 and cisplatin (80 mg/m(2)) on Day 7 followed by radiotherapy with 30 Gy. Additional chemoradiotherapy was administered to responders, and laryngectomy was performed in non-responders. The contribution of alternating chemoradiotherapy to laryngeal preservation was compared with that of radiotherapy in patients with T2 disease and with that of laryngectomy in patients with T3/T4 disease.
  
  
  RESULTS
  Analysis of 87 patients was conducted. The 5-year overall survival rate of T2 patients (n = 46) was 88.9% for definitive radiotherapy and 82.5% for alternating chemoradiotherapy. The laryngectomy-free rate in T2 patients was 90.5% for definitive radiotherapy and 80.0% for alternating chemoradiotherapy. In patients with T3/T4 disease (n = 41), the 5-year overall survival rate was 86.9% for alternating chemoradiotherapy and 67.4% for laryngectomy. The laryngectomy-free rate in T3/T4 patients was 91.7% for alternating chemoradiotherapy and 0.0% for laryngectomy.
  
  
  CONCLUSIONS
  In advanced carcinoma of the larynx, alternating chemoradiotherapy treatment might enable larynx preservation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya ijichi@med.nagoya-cu.ac.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Ijichi
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hanai
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kawakita
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya.
authors.forename: Taijiro
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirakawa
authors.affiliation: Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kodaira
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya.
authors.forename: Shingo
authors.initials: S
authors.lastname: Murakami
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Hasegawa
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D007825:Laryngectomy / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D002945:Cisplatin; D005472:Fluorouracil
keywords: chemoradiotherapy; head and neck carcinoma; laryngeal carcinoma; laryngeal preservation