Abstract

Larynx preservation in locally advanced laryngeal cancer is intended to obtain cancer control and, if possible, the preservation of laryngeal anatomy and functions (speech, swallowing and airway patency). Eligibility criteria for larynx preservation strategies are medical and surgical. Medical factors include age, performance status, nutrition status and visceral functions. Surgical factors are local factors on which depends tumor resectability and post-treatment larynx functionality. Larynx preservation strategies include radiotherapy as local treatment associated with concomitant or sequential chemotherapy. Concomitant cisplatin-fluorouracil (CDDP-FU or PF) chemoradiation and docetaxel-cisplatin-fluorouracil (TPF) induction chemotherapy followed by radiation therapy increased larynx preservation and are evidence-based validated options. After TFP (docetaxel-CDDP-FU) induction chemotherapy, cetuximab-based immunotherapy with concomitant irradiation showed no superiority to concurrent cisplatin-based chemo-radiotherapy and, consequently, this combination should not be used, except for unfit patients to platinum-based regimen.

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