Laryngeal cancer medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Omer Kamal, M.D.[2]

## Overview

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The medical therapy combined with radiation has largely replaced the surgical cure for laryngeal cancer. However, the treatment truly depends on the stage at the time of diagnosis. Multiple factors should be taken into account when considering treatment such as laryngeal preservation, maintaining the airway, swallowing and speech. Induction therapy includes three cycles of continuous infusion of cisplatin (100 mg/m2 on day 1) plus fluorouracil (1000 mg/m2/day) followed by definitive radiation therapy in the induction phase and concurrent consists of cisplatin (100 mg/m2 on days 1, 22, and 43) with radiation therapy.

## Medical Therapy

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The medical therapy combined with radiation has largely replaced the surgical cure for laryngeal cancer. However, the treatment truly depends on the stage at the time of diagnosis.[1] Multiple factors should be taken into account when considering treatment: [2][3]

* Laryngeal preservation
* Maintaining the airway
* Swallowing
* Speech

### Chemotherapy:

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Chemotherapy consists of two phases:[4][5]

Induction: Three cycles of continuous infusion of cisplatin (100 mg/m2 on day 1) plus fluorouracil (1000 mg/m2/day ) followed by definitive radiation therapy in the induction phase

Concurrent: Cisplatin (100 mg/m2 on days 1, 22, and 43) with radiation therapy

### Radiation therapy

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Radiotherapy can be very helpful in preserving the larynx and voice. It has shown similar efficacy with concomitant cisplatin as the laryngectomy-free survival [6][7][8]

## References

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1. ↑ Tamura Y, Tanaka S, Asato R, Hirano S, Yamashita M, Tamaki H, Ito J (February 2007). "Therapeutic outcomes of laryngeal cancer at Kyoto University Hospital for 10 years". Acta Otolaryngol Suppl (557): 62–5. doi:10.1080/00016480601067990. PMID 17453448.
2. ↑ Lefebvre JL, Ang KK (April 2009). "Larynx preservation clinical trial design: key issues and recommendations-a consensus panel summary". Int. J. Radiat. Oncol. Biol. Phys. 73 (5): 1293–303. doi:10.1016/j.ijrobp.2008.10.047. PMID 19306746.
3. ↑ Lefebvre JL, Ang KK (April 2009). "Larynx preservation clinical trial design: key issues and recommendations--a consensus panel summary". Head Neck. 31 (4): 429–41. doi:10.1002/hed.21081. PMID 19283793.
4. ↑ Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, Glisson B, Trotti A, Ridge JA, Chao C, Peters G, Lee DJ, Leaf A, Ensley J, Cooper J (November 2003). "Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer". N. Engl. J. Med. 349 (22): 2091–8. doi:10.1056/NEJMoa031317. PMID 14645636.
5. ↑ Forastiere AA, Zhang Q, Weber RS, Maor MH, Goepfert H, Pajak TF, Morrison W, Glisson B, Trotti A, Ridge JA, Thorstad W, Wagner H, Ensley JF, Cooper JS (March 2013). "Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer". J. Clin. Oncol. 31 (7): 845–52. doi:10.1200/JCO.2012.43.6097. PMC 3577950. PMID 23182993.
6. ↑ Smee RI, Williams JR, Broadley K, Bridger GP (January 2013). "Early glottic carcinoma treated by radiotherapy: defining a population for surgical salvage". Laryngoscope. 123 (1): 171–6. doi:10.1002/lary.23663. PMID 23007323.
7. ↑ Carl J, Andersen LJ, Pedersen M, Greisen O (June 1996). "Prognostic factors of local control after radiotherapy in T1 glottic and supraglottic carcinoma of the larynx". Radiother Oncol. 39 (3): 229–33. PMID 8783399.
8. ↑ Chera BS, Amdur RJ, Morris CG, Kirwan JM, Mendenhall WM (October 2010). "T1N0 to T2N0 squamous cell carcinoma of the glottic larynx treated with definitive radiotherapy". Int. J. Radiat. Oncol. Biol. Phys. 78 (2): 461–6. doi:10.1016/j.ijrobp.2009.08.066. PMID 20153124.

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