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Giving cisplatin at the same time as radiotherapy preserved the larynx in more patients with advanced laryngeal cancer than either induction chemotherapy followed by radiotherapy or radiotherapy alone, defining the standard larynx-preserving treatment.
Phase 3 trial of 547 patients with stage III to IV laryngeal cancer randomised to induction cisplatin-fluorouracil followed by radiotherapy, concurrent cisplatin with radiotherapy, or radiotherapy alone.
Laryngectomy-free survival was similar between the chemotherapy arms, but laryngeal preservation at two years was 88 percent with concurrent chemoradiation against 75 percent with induction and 70 percent with radiotherapy alone, and locoregional control was best with concurrent treatment; overall survival was similar in all arms.
Concurrent cisplatin chemoradiation is the standard larynx-preserving treatment for advanced laryngeal cancer where the larynx is still functioning; laryngectomy is reserved for extensive disease or salvage.
Shares Laryngeal and hypopharyngeal cancer, New England Journal of Medicine.