Related Experiment Videos
Larynx preservation: the discussion is not closed
1Head and Neck Department, Centre Oscar Lambret, Lille, France.
Summary
Larynx preservation for advanced squamous cell carcinomas is feasible using induction chemotherapy followed by irradiation or surgery. This approach maintains survival rates while preserving voice function in 50-66% of patients.
Area of Science:
- Oncology
- Head and Neck Surgery
- Radiation Oncology
Background:
- Advanced larynx and hypopharynx squamous cell carcinomas are typically treated with radical surgery and irradiation, often resulting in voice box removal.
- Current treatment strategies lack direct randomized comparisons between primary surgery or irradiation.
- Induction chemotherapy shows promise in predicting treatment response and enabling larynx preservation.
Purpose of the Study:
- To evaluate the feasibility and outcomes of larynx preservation strategies for advanced squamous cell carcinomas.
- To assess the role of induction chemotherapy in guiding treatment decisions for larynx preservation.
- To review emerging treatment modalities and success parameters for laryngeal cancer.
Main Methods:
- Review of current treatment paradigms for resectable larynx and hypopharynx squamous cell carcinomas.
- Analysis of induction chemotherapy (platinum and 5-fluorouracil) for response prediction and treatment selection.
- Evaluation of larynx preservation rates and survival outcomes in patients receiving induction chemotherapy followed by tailored treatment.
Main Results:
- Induction chemotherapy with platinum and 5-fluorouracil demonstrates significant response rates and predicts radiosensitivity.
- The strategy of induction chemotherapy followed by irradiation (for responders) or surgery (for non-responders) preserves larynx function in 50% to 66% of survivors without compromising survival.
- Irradiation alone, with modified fractionation or concurrent chemotherapy, and subtotal laryngectomy are also effective options for selected cases.
Conclusions:
- Larynx preservation is a feasible strategy for advanced but resectable squamous cell carcinomas, particularly when guided by induction chemotherapy response.
- While larynx preservation is achievable, it remains an investigational approach with ongoing research into new treatments and outcome measures.
- Future directions include exploring novel biologic agents, advanced imaging, and focusing on quality of life and functional outcomes.