Journal ArticleDOI
Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer
Gregory T. Wolf,Susan G. Fisher,Waun Ki Hong,Robert E. Hillman,Monica Spaulding,George E. Laramore,James W Endicott,Kenneth McClatchey,William G. Henderson +8 more
TLDR
Preliminary results suggest a new role for chemotherapy in patients with advanced laryngeal cancer and indicate that a treatment strategy involving induction chemotherapy and definitive radiation therapy can be effective in preserving the larynx in a high percentage of patients, without compromising overall survival.Abstract:
Background We performed a prospective, randomized study in patients with previously untreated advanced (Stage III or IV) laryngeal squamous carcinoma to compare the results of induction chemotherapy followed by definitive radiation therapy with those of conventional laryngectomy and postoperative radiation. Methods Three hundred thirty-two patients were randomly assigned to receive either three cycles of chemotherapy (cisplatin and fluorouracil) and radiation therapy or surgery and radiation therapy. The clinical tumor response was assessed after two cycles of chemotherapy, and patients with a response received a third cycle followed by definitive radiation therapy (6600 to 7600 cGy). Patients in whom ther was no tumor response or who had locally recurrent cancers after chemotherapy and radiation therapy underwent salvage laryngectomy. Results After two cycles of chemotherapy, the clinical tumor response was complete in 31 percent of the patients and partial in 54 percent. After a median follow-up of 33 months, the estimated 2-year survival was 68 percent (95 percent confidence interval, 60 to 76 percent) for both treatment groups (P = 0.9846). Patterns of recurrence differed significantly between the two groups, with more local recurrences (P = 0.0005) and fewer distant metastases (P = 0.016) in the chemotherapy group than in the surgery group. A total of 59 patients in the chemotherapy group (36 percent) required total laryngectomy. The larynx was preserved in 64 percent of the patients overall and 64 percent of the patients who were alive and free of disease. Conclusions These preliminary results suggest a new role for chemotherapy in patients with advanced laryngeal cancer and indicate that a treatment strategy involving induction chemotherapy and definitive radiation therapy can be effective in preserving the larynx in a high percentage of patients, without compromising overall survival.read more
Citations
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Journal ArticleDOI
Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer
Arlene A. Forastiere,Helmuth Goepfert,Moshe H. Maor,Thomas F. Pajak,Randal S. Weber,William H. Morrison,Bonnie S. Glisson,Andy Trotti,John A. Ridge,C. Chao,Glen Peters,Ding Jen Lee,Andrea Leaf,John F. Ensley,Jay S. Cooper +14 more
TL;DR: In patients with laryngeal cancer, radiotherapy with concurrent administration of cisplatin is superior to induction chemotherapy followed by radiotherapy or radiotherapy alone for larynGEal preservation and locoregional control.
Journal ArticleDOI
Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck.
Jay S. Cooper,Thomas F. Pajak,Arlene A. Forastiere,John R. Jacobs,Bruce H. Campbell,Scott Saxman,Julie A. Kish,Harold Kim,Anthony J. Cmelak,Marvin Rotman,Mitchell Machtay,John F. Ensley,K.S.Clifford Chao,Christopher J. Schultz,Nancy M. Lee,Karen K. Fu +15 more
TL;DR: Among high-risk patients with resected head and neck cancer, concurrent postoperative chemotherapy and radiotherapy significantly improve the rates of local and regional control and disease-free survival, however, the combined treatment is associated with a substantial increase in adverse effects.
Journal ArticleDOI
Head and neck cancer.
Journal ArticleDOI
Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data
TL;DR: For larynx preservation, the non-significant negative effect of chemotherapy in the organ-preservation strategy indicates that this procedure must remain investigational and the routine use of chemotherapy is debatable.
Journal ArticleDOI
Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival.
James A. Bonner,Paul M. Harari,Jordi Giralt,Roger B. Cohen,Christopher U. Jones,Ranjan Sur,David Raben,José Baselga,Sharon A. Spencer,Junming Zhu,Hagop Youssoufian,Eric K. Rowinsky,K. Kian Ang +12 more
TL;DR: Overall survival was significantly improved in those who experienced an acneiform rash of at least grade 2 severity compared with patients with no rash or grade 1 rash, confirming cetuximab plus radiotherapy as an important treatment option in this group of patients.
References
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Journal ArticleDOI
Speech and survival: tradeoffs between quality and quantity of life in laryngeal cancer.
TL;DR: The principles of expected utility theory are used to develop a method for sharpening decisions involving tradeoffs between quantity and quality of life and suggest that treatment choices should be made on the basis of patients' attitudes toward the quality as well as the quantity of survival.
Journal ArticleDOI
Correlation between response to cisplatinum‐combination chemotherapy and subsequent radiotherapy in previously untreated patients with advanced squamous cell cancers of the head and neck
John F. Ensley,John R. Jacobs,Arthur Weaver,Jeannie Kinzie,John D. Crissman,Julie A. Kish,Glenn Cummings,Muhyi Al-Sarraf +7 more
TL;DR: This study was comprised of 57 patients with 60 separate neoplasms who demonstrated less than complete response to initial treatment with a combination chemotherapy containing cisplatin, and radiotherapy was employed in patients with advanced squamous cell carcinoma of the head and neck.
Journal ArticleDOI
Preoperative chemotherapy in advanced resectable head and neck cancer: Final report of the southwest oncology group†
TL;DR: This final analysis demonstrates no benefit in survival using preoperative chemotherapy for advanced stage, resectable head and neck squamous cell carcinoma.
Journal ArticleDOI
An analysis of induction and adjuvant chemotherapy in the multidisciplinary treatment of squamous-cell carcinoma of the head and neck.
Thomas J. Ervin,John R. Clark,Ralph R. Weichselbaum,Barbara G. Fallon,Douglas C. Miller,Richard L. Fabian,Marshall R. Posner,C. M. Norris,Stephanie A. Tuttle,D A Schoenfeld +9 more
TL;DR: In this paper, the role of combination chemotherapy with surgery and/or radiotherapy in the initial treatment of patients with advanced stage III and IV squamous-cell carcinoma of the head and neck (SCCHN) was examined.
Journal ArticleDOI
Chemotherapy as a substitute for surgery in the treatment of advanced resectable head and neck cancer. A report from the northern California oncology group
TL;DR: It is suggested that for patients with resectable disease who achieve a complete pathologic response to induction chemotherapy at their primary, it is feasible to omit surgery and treat with primary radiation without compromise in survival.
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