Chemoradiation Study aims for 80% Survival in Laryngeal Cancer

BERLIN (Reuters Health) - A new study into the effect of combined radiotherapy and chemotherapy in patients with advanced laryngeal cancer hopes to produce survival and larynx conservation rates of up to 80%.

It follows work with smaller patient groups by the same researchers involving concurrent chemoradiotherapy that achieved remission rates of 71% a year after treatment, and an American study that produced remission and organ retention rates of 88%.

Dr. Andreas Dietz, from the Ear, Nose and Throat University Clinic in Heidelberg, conducted the initial work and is leading the new study--bigger than the others--which is expected to involve 150 patients.

"We are in the middle of the work. It started in May 2002 and will involve chemotherapy using Taxol and cisplatin followed by radiotherapy. We expect 80% survival and retention rates after 3 years, that is what we are working towards," he told Reuters Health.

"So far it is encouraging. The problem with the first study was that we treated all the patients, but with this one we can see first if the patients respond to the chemotherapy before progressing."

Dr. Dietz's protocol paper on the study states that the patients will be offered the choice between the standard surgery and the larynx-sparing attempt.

Patients who opt for the laryngectomy will also be observed and the results documented to give indications of how many patients might be suitable for a larynx-retaining programme as well as the level of acceptance of such therapy.

Chemoradiation Study aims for 80% Survival in Laryngeal Cancer

he aim is to recruit 150 patients within 3 years for the study which will observe them for at least two years, according to the paper (available in German at http://www.delos.de.vu).

Patients will be given the first cycle of chemotherapy involving an infusion of paclitaxel (Taxol) at 200mg/m² and then 100 mg/m² cisplatin.

A second cycle follows after 3 weeks and then after 2 further weeks remission status is recorded. If there is no change or even progression of the tumour, a laryngectomy is performed.

Those patients who have responded to the chemotherapy are then given radiotherapy. After the therapy the patients are examined every 6 weeks for 6 months and then every 3 months for 2 years.

Standard therapy in Germany for patients with advanced laryngeal cancer is laryngectomy, often followed by radiotherapy, while alternatives are not recommended as standard therapy.

But in international medicine moves are being made to establish a therapeutic model which has similar survival rates as the standard therapy but which enables some of the patients to retain their larynxes.

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