Treatment results of neo-adjuvant chemotherapy in advanced laryngeal carcinoma in upper Egypt

Abstract EN

Background: Laryngeal carcinoma constitutes a major part of head & neck tumours.

A prospective single arm study was planned to evaluate the safety and efficacy of neo-adjuvant chemotherapy regimen (PFL), cisplatin (P), fluorouracil (F), and leucovorine (L) in the management of patients with locally advanced laryngeal cancer in Upper Egypt.

Patients & Methods: The study was carried out between the clinical oncology and ENT Departments, Assiut University Hospital, Egypt.

Eligible, previously untreated, patients with locally advanced Laryngeal carcinoma were included between April 1997 and September 1998.

Maximum of 3 cycles of chemotherapy were given followed by local treatment according to degree of response.

Results: 31 eligible patients, stage III disease reported in 52% of cases and stage IV reported in 48%.

Assessment after neo-adjuvant chemotherapy showed overall response in 20 patients (65%), complete response (CR) in 23% and partial response (PR) in 42%, stable disease (SD) in 19% and progressive disease (PD) in 16%.

Six patients underwent post chemotherapy total laryngectomy and 20 patients had radical radiotherapy.

After completion of local treatment, CR was reported in 20 out of the 26 patients (77%) and PR in 6 patients (23%).

The preservation of larynx was achieved in 20 patients of the whole studied group (65%).

The disease free period (DFP) was significantly affected by primary response to chemotherapy and tumour stage.

The overall survival ) OS) was not significantly affected by chemotherapy or method of local treatment.

Conclusions: Laryngeal carcinoma constitutes about 60% of Head & neck tumours.

Neo- adjuvant chemotherapy PFL is tolerable and potentially effective together with local treatment in the management of locally advanced laryngeal cancer