European Archives of Oto-Rhino-Laryngology

, Volume 266, Issue 5, pp 719–726

Organ preservation in locally advanced head and neck cancer of the larynx using induction chemotherapy followed by improved radiation schemes

  • Giovanni Franchin
  • Emanuela Vaccher
  • Doriano Politi
  • Emilio Minatel
  • Carlo Gobitti
  • Renato Talamini
  • Simon Spazzapan
  • Maria Gabriella Savignano
  • Mauro G. Trovò
  • Luigi Barzan
Head and Neck

DOI: 10.1007/s00405-008-0798-2

Cite this article as:
Franchin, G., Vaccher, E., Politi, D. et al. Eur Arch Otorhinolaryngol (2009) 266: 719. doi:10.1007/s00405-008-0798-2

Abstract

The present prospective study seeks to evaluate overall and disease free survival, response and organ preservation rate, and toxicity of an intensive chemotherapy regimen (CT) followed by unconventional radiotherapy (RT) in patients with locally advanced operable head and neck cancer. Between January 1998 and December 2006 (June 2005), 115 patients with locally advanced, operable head and neck cancer were evaluated. A total of 333 cycles of neoadjuvant CT (cisplatin–5FU, days 1, 14, 28) followed by hyperfractionated/accelerated radiotherapy were given to 108 patients. A total of 108 patients were evaluable and received the planned CT–RT treatment. Two months after the end of RT, 97.2% of patients had a clinical complete remission of the primary and 67.5% of the neck node site. The overall survival was 55% and cause-specific survival was 73% at 5 years. Of the 33 relapsed patients, 12 recurred only at the primary site and 10 patients had distant metastases. The overall organ preservation rate was 73.5%. The chemotherapy regimen reported an overall cardiotoxicity from 5FU in 14% of patients, with severe toxicity in 3%. The radiotherapy schedule developed 84% of Grade 3–4 mucositis in the observed patients. The accelerated CT–RT regimen is able to achieve a high rate of larynx preservation, a good tolerability, and a satisfactory cause-specific overall survival.

Keywords

Unconventional radiotherapy Intensive chemotherapy Larynx Phase II study Organ preservation 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Giovanni Franchin
    • 1
  • Emanuela Vaccher
    • 2
  • Doriano Politi
    • 3
  • Emilio Minatel
    • 1
  • Carlo Gobitti
    • 1
  • Renato Talamini
    • 4
  • Simon Spazzapan
    • 2
  • Maria Gabriella Savignano
    • 3
  • Mauro G. Trovò
    • 1
  • Luigi Barzan
    • 3
  1. 1.Department of Radiation TherapyCentro di Riferimento Oncologico, National Cancer InstituteAvianoItaly
  2. 2.Department of Medical Oncology ACentro di Riferimento Oncologico, National Cancer InstituteAvianoItaly
  3. 3.Head and Neck DepartmentSanta Maria degli Angeli General HospitalPordenoneItaly
  4. 4.Unit of Epidemiology and BiostatisticsCentro di Riferimento Oncologico, National Cancer InstituteAvianoItaly

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