Is treatment with chemotherapy alone feasible for advanced laryngeal or hypopharyngeal squamous cell carcinoma?
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October 2010Background: A favorable response to induction chemotherapy has been shown to be predictive of response to chemoradiation in patients with advanced laryngeal squamous cell cancer. Because of the adverse long-term sequelae of radiation therapy, including fibrosis and dysphagia, this study sought to determine if patients with advanced laryngeal cancer who had a favorable response to one cycle of induction chemotherapy could be successfully treated with subsequent chemotherapy alone.
Study design: Single arm phase II trial of patients with stage III or IVA laryngeal or hypopharyngeal cancer. All patients underwent induction chemotherapy with one cycle of cisplatin or carboplatin + 5-fluorouracil (5-FU). Patients with a complete clinical and histological response (measured by biopsy) after induction chemotherapy underwent subsequent treatment with chemotherapy alone, consisting of three additional alternating cycles of chemotherapy: cisplatin or carboplatin + 5-FU for cycles two and four, and weekly docetaxel for three weeks comprising the third cycle. Patients with a partial response to induction chemotherapy, defined as >50 percent reduction in primary tumor size, underwent concurrent chemoradiotherapy with cisplatin or carboplatin.