Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T18:11:50.720Z Has data issue: false hasContentIssue false
  • English
  • Français

Larynx preservation after initial non-cisplatin containing combination chemotherapy plus radiotherapy, as opposed to surgical intervention with or without radiotherapy in previously untreated advanced head and neck cancer: final analysis after 12 years follow-up

Published online by Cambridge University Press:  29 June 2007

L. A. Price ,
H. J. Shaw  and
Bridget T. Hill
L. A. Price
Affiliation:
111 Harley Street, London W1N 1DG, UK.
H. J. Shaw
Affiliation:
Chairman (Retired), Head and Neck Unit, Royal Marsden Hospital, London SW3 6JJ, UK
Bridget T. Hill*
Affiliation:
Cellular Chemotherapy Laboratory, Imperial Cancer Research Fund, London WC2A 3PX, UK.
*
Dr B. T. Hill, Cellular Chemotherapy Laboratory, Imperial Cancer Research Fund, PO Box 123, 44 Lincoln's Inn Fields, London WC2A 3PX.
Get access Rights & Permissions [Opens in a new window]

Abstract

After a median follow-up of 12 years, median overall survival of 73 patients with advanced squamous cell carcinoma of the larynx was 65 months. The 61 per cent of patients responding to two courses of initial schedule A combination chemotherapy, not including cisplatin, and the 81 per cent of patients achieving a final complete remission after definitive local therapy, had median overall survival figures of 95 and 97 months respectively. Overall survival and relapse-free survival in 51 patients treated with radiotherapy only with larynx preservation, were not significantly different from the 21 patients who completed their surgery with pre- or postoperative radiotherapy: median overall figures were 71 versus 65 months. These data add weight to our proposal that use of initial combination chemotherapy followed by radiotherapy may eliminate the need for radical surgery, so preserving the larynx in patients with advanced disease, and provides evidence of some long-term benefit with 32 per cent of this entire group surviving 12 years.

Keywords

Laryngeal neoplasmsCarcinoma, squamous cellLaryngectomyRadiotherapyAntineoplastic agents, combined
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 3 , March 1993 , pp. 211 - 216
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bosl, G. J., Strong, E., Harrison, L., Pfister, D. G. (1991) Chemotherapy and the management of locally advanced squamous cell carcinoma of the head and neck: role in larynx preservation. In Important Advances in Oncology 1991. (DeVita, V. T., Hellman, S., Rosenberg, S. A., eds.), J. B. Lippincott Company, Philadelphia, p 191–203.Google Scholar
Clavel, M., Maged Mansour, A. R. (1991) Head and neck cancer: Prognostic factors for response to chemotherapy. European Journal of Cancer 27: 349–356.Google Scholar
Department of Veterans Affairs Laryngeal Cancer Study Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. New England Journal of Medicine 324: 1685–1690.Google Scholar
Forastiere, A. A. (1991) Randomized trials in induction chemotherapy: a critical review. In Hematology and Oncology Clinics of North America. (Vokes, E. E., ed.), W. B. Saunders Co., Philadelphia, vol. 5, p 725–736.Google Scholar
Hill, B. T., Price, L. A. (1990) The role of adjuvant chemotherapy in the treatment of advanced head and neck cancer. Acta Oncologia 29: 695–703.Google Scholar
Hill, B. T., Price, L. A., Love, S. (1988) Induction combination chemotherapy without cisplatin followed by radiotherapy without radical surgery as definitive treatment for advanced laryngeal cancer. In Neo-Adjuvant Chemotherapy. (Jacquillat, C. M., Weil, M., Khayat, D., eds.), Colloque INSERM/John Libbey Eurotext Ltd., London, Vol. 169, p. 303–308.Google Scholar
Hill, B. T., Price, L. A., MacRae, K. (1986) Importance of primary site in assessing chemotherapy response and seven-year survival data in advanced squamous-cell carcinomas of the head and neck treated with initial combination chemotherapy without cisplatin. Journal of Clinical Oncology 7: 335–340.Google Scholar
Karp, D., Carter, R., Vaughan, C., Willett, B., Heeren, T., Calarese, P., Zeitels, S., Hong, W. (1988) Voice preservation using induction chemotherapy plus radiation therapy as an alternative to laryngectomy in advanced head and neck cancer: Long term follow up. Proceedings of the American Society of Clinical Oncology 7: 152.Google Scholar
Karp, D. D., Vaughan, C. W., Carter, R., Willett, B., Heeren, T., Calarese, P., Zeitels, S., Strong, S., Hong, W. K. (1991) Larynx preservation using induction chemotherapy plus radiation therapy as an alternative to laryngectomy in advanced head and neck cancer: A long-term follow-up report. American Journal of Clinical Oncology 14: 273–279.Google Scholar
Jacobs, C., Goffinet, D. R., Kohler, M., Fee, W. E. (1987) Chemotherapy as a substitute for surgery in the treatment of advanced resectable head and neck cancer: A report from the Northern California Oncology Group. Cancer 60: 1178–1183.Google Scholar
Jacobs, C., Makuch, R. (1990) Efficacy of adjuvant chemotherapy for patients with resectable head and neck cancer: A subset analysis of the head and neck contracts program. Journal of Clinical Oncology 8: 838–847.Google Scholar
Pfister, D., Bosl, G. J., Vikram, B., Gerold, G., Shah, J., Sessions, R., Strong, E. (1986) Larynx preservation in patients with advanced head and neck cancer: Neoadjuvant chemotherapy and primary radiation therapy. Proceedings of the American Society of Clinical Oncology 5: 140.Google Scholar
Pfister, D. G., Strong, E., Harrison, L., Haines, I. E., Pfister, D. A., Sessions, R., Spiro, R., Shah, J., Gerold, F., McVure, T., Vikram, F., Fass, D., Armstrong, J., Bosl, G. J. (1991) Larynx preservation with combined chemotherapy and radiation therapy in advanced but resectable head and neck cancer. Journal of Clinical Oncology 9: 850–859.CrossRefGoogle ScholarPubMed
Price, L. A., Hill, B. T. (1977) A kinetically-based logical approach to the chemotherapy of head and neck cancer. Clinical Otolaryngology 2: 339–345.CrossRefGoogle Scholar
Price, L. A., Hill, B. T. (1982) Safe and effective induction chemotherapy without cisplatin for squamous cell carcinoma of the head and neck: Impact on complete response rate and survival at five years, following local therapy. Medical and Pediatric Oncology 10: 535–548.Google Scholar
Price, L. A., MacRae, K., Hill, B. T. (1983) Integration of safe initial combination chemotherapy (without cisplatin) with a high response rate and local therapy for untreated Stage III and IV epidermoid cancer of the head and neck: Five-year data. Cancer Treatment Reports 67: 535–539.Google Scholar
Shirinian, M., Weber, R., Dimery, I., Choski, A. J., Kramer, A..Heyne, K., Goepfert, H., Byers, R., Hong, W. K. (1992) Laryngeal preservation using induction chemotherapy followed by definitive radiation therapy for patients with advanced stage head and neck squamous cell carcinoma requiring a total laryngectomy. Proceedings of the American Society of Clinical Oncology 11: 242.Google Scholar
Urba, S., Forastiere, A. A., Wolf, G. T., Baker, S. R., Sullivan, M., Thornton, A., Husted, S. (1989) Intensive continuous infusion high dose cisplatin, 5-fluorouracil and mitoguazone induction chemotherapy for advanced head and neck cancer. Proceedings of the American Society of Clinical Oncology 8: 172.Google Scholar
Vikram, B., Bosl, G. J., Pfister, D., Assad, W., Strong, E. W., Spiro, R. H., Sessions, R. B., Gerold, F. P., Shah, J. P. (1988) New strategies for avoiding total laryngectomies in patients with head and neck cancer. National Cancer Institute Monographs 6: 361–364.Google Scholar