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RTOG 91-11 established concurrent cisplatin with radiotherapy as the way to keep the voice box in advanced larynx cancer: more patients kept their larynx than with induction chemotherapy or radiotherapy alone, with no loss of survival.
RTOG 91-11 randomised 547 patients with stage III or IV larynx cancer to induction cisplatin-fluorouracil followed by radiotherapy, concurrent cisplatin with radiotherapy, or radiotherapy alone. At two years the larynx was preserved in 88 percent with concurrent chemoradiation, 75 percent with induction and 70 percent with radiotherapy alone; locoregional control was best with concurrent treatment and overall survival did not differ (Forastiere and colleagues, New England Journal of Medicine 2003). Long-term follow-up showed more non-cancer deaths after concurrent treatment, a caution about late toxicity.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
547 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Laryngectomy-free survival driver: larynx preservation at 2 yearsprimary | Concurrent cisplatin chemoradiation | 172 | 88% | - | - | - |
| Induction chemotherapy then radiotherapy | 173 | 75% | ||||
| Radiotherapy alone | 173 | 70% |
Concurrent chemoradiation remains standard, but the excess of late non-cancer deaths is a reminder that swallowing dysfunction and aspiration after chemoradiation carry long-term risk.
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 Hypopharyngeal cancer, Laryngeal and hypopharyngeal cancer, Radiosensitisers, Head and neck squamous cell carcinoma and the tag radiation-wave4.
Shares Radiosensitisers, Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), Cisplatin and the tag radiation-wave4.
Shares NRG Oncology, Chemoradiation (chemoradiotherapy, CRT), Cisplatin, Head and neck squamous cell carcinoma and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Cisplatin, Head and neck squamous cell carcinoma, IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares NRG Oncology, Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.