Sequential chemoradiotherapy in advanced laryngeal cancer: An institutional experience

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/m2 on day 1), cisplatin (75 mg/m2 on day 1) and 5-flurouracil (5-FU) (750 mg/m2 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.