Researchers from the University of Chicago have reported that chemoradiotherapy results in “promising control and functional outcomes” for patients with T4 laryngeal cancer. The details of this study were published in the September, 2008 issue of the Annals of Oncology.¹

Stage IV laryngeal cancers have spread to tissues around the larynx, such as the pharynx or the tissues in the neck. The lymph nodes may or may not contain cancer. The cancer has spread to more than one lymph node on the same side of the neck as the cancer, to lymph nodes on one or both sides of the neck, or to any lymph node that measures more than 6 centimeters. Patients are further categorized into having large-volume versus small-volume disease. Chemoradiotherapy is considered a standard approach to the treatment of T4 cancers of the larynx, but patients with large-volume disease have been excluded from most clinical trials.

The current trial involved 32 patients with both large- and small-volume T4 squamous cell carcinoma of the larynx who participated in three chemoraiotherapy trials. The latest trials included induction chemotherapy, and all included concomitant paclitaxel, 5=FU, hydroxyurea, and radiotherapy. The median follow-up was 43 months. The following table summarizes the effects of chemoradiotherapy on four-year locoregional control (LRC), disease-free survival (DFS), overall survival (OS), and laryngectomy-free survival (LFS).

Table 1: Four-year Outcomes of Chemoradiotherapy for Laryngeal Cancer

Four patients had laryngectomy for recurrent disease. Ninety percent of patients had normal or comprehensible speech at one year. Patients receiving induction chemotherapy had an improved local control rate (90%) compared with patients not having induction therapy (46%). These authors concluded that patients with large-volume disease had outcomes similar to those with small-volume disease. There was a strong suggestion that induction chemotherapy improved outcomes.

Comments: These data are consistent with other data suggesting that patients with advanced laryngeal cancer can be treated successfully with chemoradiotherapy.

Related News:

Induction Chemotherapy with Taxotere® Preserves Larynx Function (07/05/2006)

Concomitant Chemotherapy and Radiation Therapy Improve Larynx Preservation Rate in Potentially Resectable Stage III-IV Cancer of the Larynx (10/10/2002)

Reference:

¹ Knab BR, Salama JK, Solanki A, et al. Functional organ preservation with defititive chemoradiotherapy for T4 laryngeal squamous cell carcinoma. Annals of Oncology. 2008;19:1650-1654.