title: Relationship between response to induction chemotherapy and disease control in patients with advanced laryngeal carcinoma included in an organ preservation protocol.
abstract: The aim of the study is to analyze the relationship between the degree of response to induction chemotherapy and the disease control in patients with locally advanced laryngeal carcinomas candidates to total laryngectomy. This retrospective study includes 389 patients with T3-T4 laryngeal tumors candidates to total laryngectomy, diagnosed between 1985 and 2013, treated with induction chemotherapy in an organ preservation protocol. Five-year local recurrence-free survival for patients receiving conservative treatment with radiotherapy after a complete response to induction chemotherapy was 75.4%; for patients with partial response greater than 50%, it was 62.0%; and for patients with the absence of response, it was 32.7%. There were significant differences in local recurrence-free survival and laryngeal dysfunction-free survival according to the response to induction chemotherapy (P = 0.0001) at the expense of patients with absence of response to induction chemotherapy. Patients with partial response greater than 50% treated with radiotherapy had a tendency to have worse local recurrence-free survival and laryngeal dysfunction-free survival than patients with complete response, but the differences did not reach statistical significance. Patients with the absence of response after induction chemotherapy had significant differences in disease-specific survival according to the second treatment: for patients treated with surgery it was 70.2%, whereas for patients treated with radiotherapy, it was 28.2% (P = 0.0001). In patients with the absence of response to induction chemotherapy, conservative treatment with radiotherapy implies a significant decrease in survival.
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 90 Mas Casanovas street, 08041, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: León
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 90 Mas Casanovas street, 08041, Barcelona, Spain. cvalero@santpau.cat.
authors.forename: Cristina
authors.initials: C
authors.lastname: Valero
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 90 Mas Casanovas street, 08041, Barcelona, Spain.
authors.forename: Carlota
authors.initials: C
authors.lastname: Rovira
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 90 Mas Casanovas street, 08041, Barcelona, Spain.
authors.forename: Camilo
authors.initials: C
authors.lastname: Rodriguez
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 90 Mas Casanovas street, 08041, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: López
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 90 Mas Casanovas street, 08041, Barcelona, Spain.
authors.forename: Jacinto
authors.initials: J
authors.lastname: García-Lorenzo
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 90 Mas Casanovas street, 08041, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Quer
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D007830:Larynx / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D059351:Organ Sparing Treatments / Q000379:methods*; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Advanced laryngeal carcinoma; Induction chemotherapy; Organ preservation protocol; Radiotherapy; Total laryngectomy