Laryngeal Organ Preservation Protocols: Are They Effective?

Abstract

Objective: Understand the role of organ preservation protocol in locally advanced laryngeal carcinoma according to our experience and determine predictive factors. Method: The study selected all patients treated between 2004 and 2009. During the study period, all patients began treatment with induction chemotherapy (3 cycles of cisplatin and 5-fluoruracil in the majority of cases) followed by radiotherapy and concomitant or subsequent chemotherapy. The results were analyzed by clinical and image evaluation. Results: The study included 40 patients, with mean age of 55 years (range, 38 to 72 years), mainly men. Smoke and alcohol were present in more than 50%, and 70.7% had no comorbidities. Hypopharynx was the most common place (65.8%). At the end of induction chemotherapy 34.2% of patients had an answer >80%. The overall survival is 59% at 3 years. The relapse rate was of 24.7% with an average of time of 8 months (4 to 56 months). No statistical differences were found between different groups of TMN staging system. Conclusion: Different studies have shown that chemotherapy followed by radiotherapy is a valid alternative to surgery in locally advanced operable head and neck cancer, involving the larynx. Our study confirms these results. Local and cervical disease staging did not contribute as a predictive factor for survival or relapse.