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Inicio Acta Otorrinolaringológica Española Organ Preservation in Patients With Advanced Laryngeal Tumours. Results of Induc...
Journal Information
Vol. 72. Issue 3.
Pages 143-151 (May - June 2021)
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Vol. 72. Issue 3.
Pages 143-151 (May - June 2021)
Original article
Organ Preservation in Patients With Advanced Laryngeal Tumours. Results of Induction Chemotherapy Versus Chemoradiotherapy in Actual Clinical Practice
Preservación de órgano en pacientes con tumores avanzados de laringe. Resultados de la quimioterapia de inducción versus quimio-radioterapia en la práctica clínica real
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Xavier Leóna,b,
Corresponding author
xleon@santpau.cat

Corresponding author.
, Victoria Montoroc, Jacinto Garcíaa, Montserrat Lópeza, Nuria Farréd, Katarina Majercakovad, Óscar Gallegoe, Antonio López-Pousae, Miquel Quera,b
a Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
b Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
c Servicio de Otorrinolaringología, Hospital de Mollet, Mollet del Vallés, Barcelona, Spain
d Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
e Servicio de Oncología Médica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
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Tables (3)
Table 1. Characteristics of the Patients Included in the Study.
Table 2. Characteristics of the Patients Included in a Preservation Protocol According to Whether Initially Treated With Induction Chemotherapy (CT) or Chemoradiotherapy (CT-RT).
Table 3. Multivariate Analysis Considering Loss of Laryngeal as the Dependent Variable.
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Abstract
Introduction and objectives

A high percentage of patients with locally advanced laryngeal carcinoma are candidates for inclusion in organ preservation protocols. The aim of this study was to compare in actual clinical practice the results of two preservation schemes, induction chemotherapy versus chemoradiotherapy, in patients with locally advanced laryngeal carcinoma.

Methods

Retrospective study conducted in 157 patients with locally advanced laryngeal tumours (T3-T4) treated with induction chemotherapy (n=121) or chemoradiotherapy (n=36).

Results

Of the 121 patients who started treatment with induction chemotherapy, 6 died as a result of toxicity, 37 were treated with surgery, and 78 completed the preservation scheme; 36 patients were treated with chemoradiotherapy. There was no significant difference in specific survival at 5 years according to whether the patients had started treatment with either induction chemotherapy or chemoradiotherapy (68.9% versus 75.7%, P=.259). A total of 45.9% of the patients achieved preservation of laryngeal function. There was a tendency for patients treated with chemotherapy to achieve laryngeal dysfunction-free survival at 5 years, which was higher than the patients treated with induction chemotherapy (55.6% versus 44.8%, P=.079).

Conclusion

The patients included in a preservation protocol achieved 45.9% laryngeal dysfunction-free survival at 5 years. No significant difference in specific survival was observed between patients treated with induction chemotherapy or chemoradiotherapy.

Keywords:
Laryngeal carcinoma
Induction chemotherapy
Chemoradiotherapy
Organ preservation
Total laryngectomy
Laryngeal dysfunction-free survival
Resumen
Introducción y objetivos

Un porcentaje elevado de pacientes con carcinomas localmente avanzados de laringe son candidatos a ser incluidos en protocolos de preservación de órgano. El objetivo del presente estudio es comparar los resultados de dos esquemas de preservación, quimioterapia de inducción versus quimio-radioterapia, en pacientes con carcinomas de laringe localmente avanzados en un contexto de práctica clínica real.

Métodos

Estudio retrospectivo realizado en 157 pacientes con tumores localmente avanzados de laringe (T3-T4) tratados con quimioterapia de inducción (n=121) o quimio-radioterapia (n=36).

Resultados

De los 121 pacientes que iniciaron tratamiento con quimioterapia de inducción, 6 fallecieron como consecuencia de toxicidad, 37 fueron tratados con cirugía, y 78 completaron el esquema de preservación; 36 pacientes recibieron un tratamiento con quimio-radioterapia. No existieron diferencias significativas en la supervivencia específica a los 5 años en función de que los pacientes iniciasen un tratamiento con quimioterapia de inducción o quimio-radioterapia (68,9% versus 75,7%, P=0,259). Un 45,9% de los pacientes consiguió una preservación de la función laríngea. Los pacientes tratados con quimio-radioterapia tuvieron una tendencia a conseguir una supervivencia libre de pérdida de la función laríngea a los 5 años superior a la de los pacientes tratados con quimioterapia de inducción (55,6% versus 44,8%, P=0,079).

Conclusión

Los pacientes incluidos en un protocolo de preservación consiguieron una supervivencia libre de disfunción laríngea a los 5 años del 45,9%. No se observaron diferencias significativas en la supervivencia específica entre los pacientes tratados con quimioterapia de inducción o quimio-radioterapia.

Palabras clave:
Carcinomas de laringe
Quimioterapia de inducción
Quimio-radioterapia
Preservación de órgano
Laringectomía total
Supervivencia libre de disfunción laríngea

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