MHNC: Chemo, radiation preserves larynx in head and neck cancer patients

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In a study evaluating the use of induction chemotherapy followed by radiation for larynx preservation in  head and neck cancer patients, researchers of the Bretonneau Hospital in Tours, France found that half of patients reported no trouble eating or swallowing and most had a low-risk of voice disability after procedure, according to a presentation Feb. 25 at the Multidisciplinary Head and Neck Cancer (MHNC) Symposium.

“Total laryngectomy is the standard treatment for locally advanced larynx cancer,” noted Gilles Calais, MD, however, “this surgical procedure could cure a lot of patients but the price to pay is the ablation of the vocal organ and the need to have a permanent tracheotomy for breathing,” he said.

Calais and colleagues evaluated 213 patients who received induction chemotherapy with ciplatin and 5FU without PF (103 patients) or with docetaxel (TPF) followed by radiation (110 patients) to analyze voice quality and nutritional function.

After averaging the PF and TPF arm, researchers found that the laryngo-esophageal dysfunction free-survival (LEDFS) was 28 percent after a median follow up of five years. In addition, only 15 percent of patients reported having a severe voice disability after procedure, while 57 percent had a voice disability deemed as minor.

"For cancer patients receiving treatment to their larynx, it is important to preserve the organ, but it is more important to preserve the function of this organ,” said Calais.

After analysis, researchers found that only 8 percent of patients necessitated a feeding tube, 27 percent used nutritional supplements and 40 percent had no eating or swallowing problems. Three percent of patients needed a tracheotomy, according to the researchers.

“Using this parameter the probability to be alive at five years with an intact larynx and a functional organ is 36 percent using the best chemotherapy regime, which is TPF,” Calais concluded.