Sequential chemoradiotherapy in advanced laryngeal cancer: an institutional experience

Asia Pac J Clin Oncol. 2010 Jun;6(2):106-10. doi: 10.1111/j.1743-7563.2010.01289.x.

Abstract

Aim: The objective of this study was to determine the efficacy of sequential chemoradiation for larynx preservation.

Methods: 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.

Results: 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.

Conclusion: Sequential chemotherapy with docetaxel, cisplatin and 5-flurouracil followed by radiation may be an alternative to a laryngectomy in patients with advanced laryngeal cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Docetaxel
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Laryngeal Neoplasms / drug therapy*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Radiotherapy, Adjuvant
  • Taxoids / administration & dosage

Substances

  • Taxoids
  • Docetaxel
  • Cisplatin
  • Fluorouracil