Treatment selection may improve outcomes in laryngeal cancer

A new treatment paradigm for advanced laryngeal cancer may help preserve the larynx and improve overall survival rates, according to a report in the February 1st issue of the Journal of Clinical Oncology.

Lead investigator Dr. Susan Urba told Reuters Health that “early identification of the best treatment for a patient – chemoradiation versus surgery – can be made based on the response to one cycle of chemotherapy, and this may allow the patient to have the best chance for survival.”Dr. Urba and colleagues at the University of Michigan Comprehensive Cancer Center, Ann Arbor investigated whether late salvage surgery rates could be decreased and survival improved by selecting patients for organ preservation based on their response to a single cycle of induction chemotherapy. Seventy-three of 97 patients (75%) had more than a 50% response to one cycle of induction chemotherapy at the primary tumor site and proceeded to definitive chemoradiotherapy, the authors report. Nineteen of 22 patients with less than a 50% response underwent planned salvage surgery.Overall, the estimated survival rates were 88% at two years and 85% at three years, the researchers note. Cause-specific survival rates were 89% at two years and 87% at three years. Estimated disease-free survival rates were 80% at two years and 78% at three years. There were no significant differences between survival rates for patients requiring planned early laryngectomy and patients with successful organ preservation.”Larynx cancer is a relatively chemosensitive disease,” Dr. Urba pointed out, “and it typically responds quickly or not very well at all.””While our study is a Phase II trial, and therefore we cannot make a definite conclusion about survival benefit,” she concluded, “our survival curve does appear promising compared to historical controls. We think that the role of early salvage surgery for patients whose tumor doesn’t respond to chemotherapy accounts for this.” (Source: J Clin Oncol 2006;24:593-598: Reuters Health: Oncolink: February 2006.)