title: Comparison of outcome and toxicity of two different regimes of neoadjuvant chemotherapy followed by external beam radiotherapy in stages III and IV larynx and laryngopharyngeal malignancies in years 2013-2014.
abstract: BACKGROUND
  Both induction chemotherapy (ICT) followed by irradiation and concurrent chemotherapy and radiotherapy have been reported as valuable alternatives to total laryngectomy in patients with advanced larynx/hypopharynx cancer.
  
  
  METHODS
  Of the 60 enrolled patients, randomly assigned into two groups (30 in each group) previously untreated patients with stages III to IV larynx/hypopharynx squamous cell carcinoma were assigned to received two cycles of ICT with interval of 3 weeks (a) Group A paclitaxel 175 mg/m 2 on day 1 and carboplatin 450 mg on day 2 (PC), (b) Group B docetaxel and cisplatin 75 mg/m 2 each on day 1 and ifosfamide 2 g/m 2 on day 1-3 along with mesna (docetaxel-ifosfamide-cisplatin). Both groups were followed by conventional radiotherapy (60-70 Gy/5#/week). Primary end point was a response after ICT. Secondary endpoints included acute toxicities and overall response.
  
  
  RESULTS
  Baseline patient and tumor characteristics were well balanced between both groups, the response after ICT seen was 80% in Group A complete response (CR) 36.6% and partial response (PR) 43.3% and in Group B 79% response, CR 33% and PR 46%; whereas toxicities in Group B grade 3/4 neutropenia and grade 2/3 vomiting more severe than Group A. Radiation therapy was well tolerable to both groups with mild side effects.
  
  
  CONCLUSIONS
  Definite role of neoadjuvant chemotherapy in locally advanced larynx/laryngopharyngeal cancer as organ preservation therapy. The efficacy found was quite similar and improved response in both groups except toxicity profile of Group B more severe, requiring the use of colony stimulating factors and supportive care along with.
authors.affiliation: Department of Radiotherapy and ENT, Government of Cancer Hospital, MGM Medical College, Indore, Madhya Pradesh, India.
authors.forename: Sonu
authors.initials: S
authors.lastname: Goyal
authors.affiliation: Department of Radiotherapy and ENT, Government of Cancer Hospital, MGM Medical College, Indore, Madhya Pradesh, India.
authors.forename: Tapesh
authors.initials: T
authors.lastname: Pounikar
authors.affiliation: Department of Radiotherapy and ENT, Government of Cancer Hospital, MGM Medical College, Indore, Madhya Pradesh, India.
authors.forename: Preety
authors.initials: P
authors.lastname: Jain
authors.affiliation: Department of Radiotherapy and ENT, Government of Cancer Hospital, MGM Medical College, Indore, Madhya Pradesh, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Arya
authors.affiliation: Department of Radiotherapy and ENT, Government of Cancer Hospital, MGM Medical College, Indore, Madhya Pradesh, India.
authors.forename: Jagram
authors.initials: J
authors.lastname: Verma
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016896:Treatment Outcome