Adjuvant chemotherapy in the treatment of pharyngolaryngeal cancers in advanced stages

: Since 1980 we use adjuvant chemotherapy in advanced laryngopharyngeal carcinomas. These cases were resectable and unresectable lesions with tumoral extent to the pharynx as a common characteristic. We analyze the survival of the first 50 cases treated with chemotherapy followed by: A) surgery and radiotherapy (36 cases) and B) radiotherapy alone (14 cases). Results of this not randomized study are compared with a historic group of advanced laryngopharyngeal carcinomas (T4/N+) treated with conventional therapy (surgery +/- radiotherapy). Response to chemotherapy was complete or partial (> 50% reduction) in 56 percent of the patients. There was improvement in overall survival and five-years disease-free survival in the latter group compared with those who did show any response (p < 0.01). We would point out that disease-free survival of the group A was better than historic group (60% vs 36%, p < 0.05), although these result should be carefully interpreted. Laryngeal preservation was achieved in 47 percent in the group A by modification of the initially scheduled radical surgery, in selected cases.