54498
document
Laryngeal preservation with induction chemotherapy for hypopharyngeal squamous cell carcinoma : 10-year results of EORTC trial 24891 . BACKGROUND We report the 10-year results of the EORTC trial 24891 comparing a larynx-preservation approach to immediate surgery in hypopharynx and lateral epilarynx squamous cell carcinoma . MATERIAL AND METHODS Two hundred and two patients were randomized to either the surgical approach ( total laryngectomy with partial pharyngectomy and neck dissection , followed by irradiation ) or to the chemotherapy arm up to three cycles of induction chemotherapy ( cisplatin 100 mg/m ( 2 ) day 1 + 5-FU 1000 mg/m ( 2 ) day 1-5 ) followed for complete responders by irradiation and otherwise by conventional treatment . The end points were overall survival [ OS , noninferiority : hazard ratio ( preservation/surgery ) ≤ 1.428 , one-sided α = 0.05 ] , progression-free survival ( PFS ) and survival with a functional larynx ( SFL ) . RESULTS At a median follow-up of 10.5 years on 194 eligible patients , disease evolution was seen in 54 and 49 patients in the surgery and chemotherapy arm , respectively , and 81 and 83 patients had died . The 10-year OS rate was 13.8 % in the surgery arm and 13.1 % in the chemotherapy arm . The 10-year PFS rates were 8.5 % and 10.8 % , respectively . In the chemotherapy arm , the 10-year SFL rate was 8.7 % . CONCLUSION This strategy did not compromise disease control or survival ( that remained poor ) and allowed more than half of the survivors to retain their larynx .
54499
Intervention_Pharmacological
induction chemotherapy
54500
Intervention_Surgical
larynx-preservation approach
54501
Intervention_Surgical
immediate surgery
54502
Intervention_Surgical
total laryngectomy with partial pharyngectomy and neck dissection ,
54503
Intervention_Pharmacological
chemotherapy
54504
Intervention_Pharmacological
irradiation
54505
Outcome_Mortality
overall survival
54506
Participant_Condition
hypopharyngeal squamous cell carcinoma :
54507
Participant_Condition
larynx-preservation approach to immediate surgery in hypopharynx and lateral epilarynx squamous cell carcinoma
54508
Participant_Sample-size
Two hundred and two patients
54509
Participant_Sample-size
194