Induction chemotherapy for organ preservation in advanced laryngeal cancer: Is there a role?

Head & Neck ◽  
1995 ◽  
Vol 17 (4) ◽  
pp. 279-283 ◽  
Author(s):  
Gregory T. Wolf ◽  
Waun Ki Hong
Head & Neck ◽  
2016 ◽  
Vol 39 (2) ◽  
pp. 227-233 ◽  
Author(s):  
Aron Popovtzer ◽  
Hanna Burnstein ◽  
Salomon Stemmer ◽  
Dror Limon ◽  
Ohad Hili ◽  
...  

2006 ◽  
Vol 24 (4) ◽  
pp. 593-598 ◽  
Author(s):  
Susan Urba ◽  
Gregory Wolf ◽  
Avraham Eisbruch ◽  
Francis Worden ◽  
Julia Lee ◽  
...  

Purpose Primary chemoradiotherapy in patients with advanced laryngeal cancer can achieve high rates of organ preservation without sacrificing survival compared with radiation alone or conventional laryngectomy. Appropriate selection of patients for organ preservation approaches could enhance overall treatment outcome and quality of life. We conducted a phase II organ preservation trial for patients with stage III and IV larynx cancer to determine whether late salvage surgery rates could be decreased and survival improved by selecting patients for organ preservation based on response to a single cycle of induction chemotherapy. Patients and Methods The chemotherapy was cisplatin 100 mg/m2 on day 1 and fluorouracil 1,000 mg/m2/d for 5 days. Patients who achieved less than 50% response had immediate laryngectomy. Patients who achieved more than 50% response went on to concurrent chemoradiotherapy. Histologic complete responders after chemoradiotherapy received two more cycles of chemotherapy. Patients with residual disease after chemoradiotherapy had planned salvage surgery. Results Of 97 eligible patients, 73 (75%) achieved more than 50% response and received chemoradiotherapy. A total of 29 patients (30%) had salvage surgery; 19 patients (20%) had early salvage surgery after the single cycle of induction chemotherapy, three patients (3%) had late salvage surgery after chemoradiotherapy, six patients (6%) eventually had salvage surgery for recurrence, and one patient had laryngectomy for chondroradionecrosis. The median follow-up time was 41.9 months. The overall survival rate at 3 years is 85%. The cause-specific survival rate was 87%. Larynx preservation was achieved in 69 patients (70%). Conclusion These results confirm excellent larynx preservation and improved overall survival rates compared with historical results.


1995 ◽  
Vol 113 (4) ◽  
pp. 408-412 ◽  
Author(s):  
C BRADFORD ◽  
S ZHU ◽  
G WOLF ◽  
J POORE ◽  
S FISHER ◽  
...  

2005 ◽  
Vol 28 (4) ◽  
pp. 371-378 ◽  
Author(s):  
Beverly A. Guadagnolo ◽  
Robert I. Haddad ◽  
Marshall R. Posner ◽  
Linda Weeks ◽  
Lori J. Wirth ◽  
...  

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1735
Author(s):  
Patricia García-Cabo ◽  
Fernando López ◽  
Mario Sánchez-Canteli ◽  
Laura Fernández-Vañes ◽  
César Álvarez-Marcos ◽  
...  

Background: We performed a comparative analysis between an organ-preservation protocol and surgery followed by radiotherapy in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx; Methods: 60 previously untreated patients who were treated with induction chemotherapy followed by chemoradiotherapy in responders were compared with a control group of 60 patients treated with up-front surgery. Both groups were statistically comparable, according to the subsite, TNM (tumor-node-metastasis) stage, age, and sex; Results: Mean age was 58 years and 92% were male. No significant statistical difference was observed for overall survival (OS) (HR 0.75; 95% CI 0.48–1,18; P = 0.22) and disease-specific survival (DSS) (HR 0.98; 95% CI 0.52–1.83, P = 0.96). Also, there was no significant difference for recurrence-free survival (HR 0.931; 95% CI 0.57–1.71; P = 0.81), metastases-free survival (HR 2.23; 95% CI 0.67–7.41; P = 0.19), and the appearance of second primary tumors (HR 1.22; 95% CI 0.51–2.88; P = 0.64); Conclusions: The results of the organ-preservation approach did not appear inferior to those of surgery plus (chemo)radiotherapy for patients with T3/T4a larynx and T2–T4a hypopharynx cancer with respect to OS and DSS, locoregional control and metastases-free survival.


2018 ◽  
Vol 10 (1) ◽  
pp. 149-155 ◽  
Author(s):  
Narayana Subramaniam ◽  
Deepak Balasubramanian ◽  
Rithvik Reddy ◽  
Krishnakumar Thankappan ◽  
Subramania Iyer

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