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T3–T4 Squamous Cell Carcinoma of the Larynx Treated With Radiation Therapy Alone or Combined With Adjuvant Chemotherapy

  • Chapter
Squamous Cell Head and Neck Cancer

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

Depending on the site and extent of disease, treatment alternatives for T3–T4 cancers include partial laryngectomy, total laryngectomy, and radiation therapy (RT) alone or combined with adjuvant chemotherapy. The prevailing treatment philosophy varies significantly from one country to another (1). Patients in the United States and Australia are usually treated surgically, which often necessitates total laryngectomy (1). In contrast, patients in Canada and Great Britain are often treated with RT alone, with surgery reserved as salvage treatment for those who experience recurrent disease. Patients treated with RT in the United States sometimes receive induction chemotherapy before RT (2). The rationale for this strategy is based on the Veterans Affairs Laryngeal Cancer Study Group trial which compared induction chemotherapy and RT (in the subset of patients who responded to chemotherapy) with initial laryngectomy and postoperative RT; survival rates were similar, and patients randomized to the induction chemotherapy arm had a higher rate of laryngeal voice preservation (3). A similar trial conducted by the European Organization for Research and Treatment of Cancer (EORTC) evaluated induction chemotherapy followed by RT for patients who had a complete response to treatment for advanced pyriform sinus and aryepiglottic fold malignancies (4). Patients randomized to receive induction chemotherapy had 5-yr survival rates similar to those for patients randomized to undergo initial surgery. Approximately one-third of patients who received induction chemotherapy retained their larynx. More recently, concomitant chemoradiation has gained popularity because it has been shown to improve survival compared with RT alone for patients with local-regionally advanced head and neck cancer.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Florida Health Science Center, Gainesville, FL

    William M. Mendenhall MD

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  1. William M. Mendenhall MD
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  1. Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH

    David J. Adelstein MD

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Mendenhall, W.M. (2005). T3–T4 Squamous Cell Carcinoma of the Larynx Treated With Radiation Therapy Alone or Combined With Adjuvant Chemotherapy. In: Adelstein, D.J. (eds) Squamous Cell Head and Neck Cancer. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59259-938-7_6

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  • DOI: https://doi.org/10.1007/978-1-59259-938-7_6

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-473-9

  • Online ISBN: 978-1-59259-938-7

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