Sequential chemoradiotherapy in advanced laryngeal cancer: An institutional experience

Abstract

The objective of this study was to determine the efficacy of sequential chemoradiation for larynx preservation. Between October 2002 and December 2007, 76 patients with T3, T4 and N+ laryngeal cancer who had refused a laryngectomy or had unresectable disease (medically or surgically) enrolled in this study. The chemotherapy consisted of three cycles of docetaxel (75 mg/m(2) on day 1), cisplatin (75 mg/m(2) on day 1) and 5-flurouracil (5-FU) (750 mg/m(2) by infusion on days 1-3). All patients were assigned to receive radiotherapy (70 Gy to primary site). The Kaplan-Meier method was used to obtain survival outcomes. The median follow up was 36 months. A chemotherapy clinical response (complete and partial) was observed in 51 patients (67.1%). The 2-year laryngeal preservation rate was 75%. Actuarial progression-free survival rates of 71% and 67% were observed at 2 and 3 years, respectively. Actuarial overall survival rates were 83% and 71% at 2 and 3 years, respectively. Disease progression was seen in 26 patients (34.2%). Grade 3 and 4 neutropenia occurred in 39 (51.3%) patients. Sequential chemotherapy with docetaxel, cisplatin and 5-flurouracil followed by radiation may be an alternative to a laryngectomy in patients with advanced laryngeal cancer.