Annals of Oncology 12:343-347, 2001
© 2001 European Society for Medical Oncology
research-article |
Sequential induction chemotherapy and concomitant chemoradiotherapy in the management of locoregionally advanced laryngeal cancer
1Department of Cellular and Radiation Oncology, M.D. Anderson Cancer Center Houston, Texas
2Department of Medicine, Section of Hematology/Oncology, M.D. Anderson Cancer Center Houston, Texas
3Cancer Research Center, University of Chicago, M.D. Anderson Cancer Center Houston, Texas
4Department of Medicine, Division of Hematology/Oncology, M.D. Anderson Cancer Center Houston, Texas
5Department of Radiation Oncology, Northwestern University Chicago, Illinois, USA
Correspondence to:D. J. Haraf, MD, University of Chicago, Department of Radiation and Cellular Oncology, 5758 South Maryland Avenue; MC 9006, Chicago, IL 60637, USA, E-mail: dharaf{at}mcis.bsd.uchicago.edu
Purpose: To determine overall survival, progression-free survival, rate of voice preservation, and patterns of failure in locoregionally advanced laryngeal cancer treated with induction chemotherapy with or without surgery followed by concomitant chemoradiation.
Background: Locoregionally advanced laryngeal cancer has been conventionally treated with either surgery and adjuvant radiotherapy or radiotherapy alone, and clinical and functional outcomes have been poor. Chemoradiotherapy has been demonstrated to improve functional outcome and disease control over conventional treatment in recent randomized head and neck trials.
Patients and methods: Advanced head and neck cancer patients were enrolled onto two consecutive phase II studies. Induction treatment consisted of three cycles of cisplatin, 5-fluorouracil (5-FU), leucovorin, and interferon-
2b (PFL-IFN) followed by surgery for residual disease. Surgical intent was to spare the larynx when possible. All patients then proceeded to concomitant chemoradiation consisting of seven or eight cycles of 5-FU, hydroxyurea, and a planned total radiotherapy dose of 7000 cGy (FHX).
Results: A subset of thirty-two laryngeal cancer patients with predominantly stage IV disease comprises the study group for this report. Clinical CR was observed in 59% of patients following induction therapy. The median follow-up was 63.0 months for surviving patients and 44.5 months for all patients. At five years, overall survival is 47%, progression-free survival is 78%, and locoregional control is 78%. No distant failures were observed. Voice preservation with disease control was 75% at five years. Only two total laryngectomies were performed during the course of treatment and follow-up. Treatment-related toxicity accounted for two deaths.
Conclusions: The addition of concomitant chemoradiotherapy to induction chemotherapy for locoregionally advanced laryngeal cancer appears to increase locoregional control and survival rates. PFL-IFN-FHX resulted in high rates of disease cure and voice preservation in a group of patients that has traditionally fared poorly in both clinical and functional outcome.
chemoradiotherapy, chemotherapy, laryngeal cancer
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. T. Milano, D. J. Haraf, K. M. Stenson, M. E. Witt, C. Eng, B. B. Mittal, A. Argiris, H. Pelzer, M. F. Kozloff, and E. E. Vokes Phase I Study of Concomitant Chemoradiotherapy with Paclitaxel, Fluorouracil, Gemcitabine, and Twice-Daily Radiation in Patients with Poor-Prognosis Cancer of the Head and Neck Clin. Cancer Res., August 1, 2004; 10(15): 4922 - 4932. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. E.W. Cohen and E. E. Vokes Searching for a Standard J. Clin. Oncol., January 15, 2002; 20(2): 359 - 361. [Full Text] [PDF]
|
|