Single Chemotherapy Dose Informs Treatment Strategy for Advanced Laryngeal Cancer

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Human larynx
Human larynx

A new approach to treating laryngeal cancer improves patient survival rate to 80%. Typically patients with advanced laryngeal cancer have a survival rate of only 50%, regardless if they undergo surgery to remove the voice box or chemotherapy and radiation.1

The head neck and oncology team at the University of Michigan Comprehensive Cancer Center developed the induction chemotherapy strategy, a new approach in which patients receive a single dose of chemotherapy. Patients who respond to the single dose can continue to receive combination chemotherapy and radiation. Those who do not respond are referred for immediate surgery.

"This approach allows us to enhance quality of life for all of our patients. Many patients can spare their voice box by having chemotherapy and radiation. But that's only good if the treatment works. For patients who must go on to receive surgery, by selecting them up front, we can spare them the complications that may occur when the voice box is removed following multiple cycles of chemotherapy with radiation," says study author Francis Worden, MD, professor of hematology/oncology.

First developed by the Michigan Medicine team in 1995, inductive chemotherapy has been offered to patients with laryngeal cancer for a decade. On average, the survival rate at 5 years for advanced laryngeal cancer patients for inductive chemotherapy was 79%, the equivalent survival rate for early stage patients. This is significantly better than a survival rate of 66% for patients undergoing chemotherapy and radiation without inductive chemotherapy.

"This adds ammunition to the idea that we need to pick individual therapies more carefully,” says Gregory T. Wolf, MD, professor and chair emeritus of otolaryngology – head and neck surgery at Michigan medicine. Inductive chemotherapy can be performed anywhere, but requires the collaborative effort of surgeons, medical oncologists and radiation oncologists, to carefully monitor the patient and recommend the best therapy.

Reference

1. Wolf GT, Bellile E, Eisbruch A, et al. Survival rates using individualized bioselection treatment methods in patients with advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg. 2017 Feb 2. doi: 10.1001/jamaoto.2016.3669 [Epub ahead of print].

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