[Induction chemotherapy and larynx preservation: is such practice useful?]

Area of Science:

• Oncology
• Head and Neck Surgery
• Radiation Oncology

Context:

• Standard treatment for laryngeal and hypopharyngeal squamous cell carcinoma (SCC) often involves total laryngectomy.
• Induction chemotherapy followed by radiotherapy is an alternative treatment modality.
• Larynx preservation is a key goal in SCC treatment, avoiding total laryngectomy.

Purpose:

• To compare the effectiveness of induction chemotherapy followed by radiotherapy versus standard treatment (surgery and radiotherapy) for larynx and hypopharynx SCC.
• To evaluate larynx preservation rates and overall survival in patients receiving induction chemotherapy.
• To assess outcomes in patients treated within a clinical trial versus those treated outside of a trial.

Summary:

• A retrospective study compared 108 patients with laryngeal or hypopharyngeal SCC treated with induction chemotherapy and radiotherapy versus surgery and radiotherapy.
• No significant difference in overall survival or larynx preservation rates was observed between the groups (55.8% vs 53.6%).
• Hematological toxicity was higher in the non-trial group, but complete response rates were similar.

Impact:

• Induction chemotherapy can achieve larynx preservation with outcomes comparable to standard treatments in daily practice.
• Further research is needed to evaluate long-term side effects and cost-effectiveness of induction chemotherapy protocols.
• Larynx preservation remains a valuable but optional treatment strategy for selected SCC patients.