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.

Keywords: chemoradiotherapy; head and neck carcinoma; laryngeal carcinoma; laryngeal preservation.