Organ Preservation in Patients With Advanced Laryngeal Tumours. Results of Induction Chemotherapy Versus Chemoradiotherapy in Actual Clinical Practice

Abstract

Introduction and objectivesA high percentage of patients with locally advanced laryngeal carcinoma are candidates for inclusion in organ preservation protocols. The aim of this study was to compare in actual clinical practice the results of two preservation schemes, induction chemotherapy versus chemoradiotherapy, in patients with locally advanced laryngeal carcinoma. MethodsRetrospective study conducted in 157 patients with locally advanced laryngeal tumours (T3-T4) treated with induction chemotherapy (n=121) or chemoradiotherapy (n=36). ResultsOf the 121 patients who started treatment with induction chemotherapy, 6 died as a result of toxicity, 37 were treated with surgery, and 78 completed the preservation scheme; 36 patients were treated with chemoradiotherapy. There was no significant difference in specific survival at 5 years according to whether the patients had started treatment with either induction chemotherapy or chemoradiotherapy (68.9% versus 75.7%, P=.259). A total of 45.9% of the patients achieved preservation of laryngeal function. There was a tendency for patients treated with chemotherapy to achieve laryngeal dysfunction-free survival at 5 years, which was higher than the patients treated with induction chemotherapy (55.6% versus 44.8%, P=.079). ConclusionThe patients included in a preservation protocol achieved 45.9% laryngeal dysfunction-free survival at 5 years. No significant difference in specific survival was observed between patients treated with induction chemotherapy or chemoradiotherapy.