Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer
N = 332
- Population
- Previously untreated stage III or IV squamous carcinoma of the larynx
- Design
- Prospective randomised study (Department of Veterans Affairs): 332 patients with previously untreated stage III or IV laryngeal squamous carcinoma were assigned to three cycles of cisplatin plus fluorouracil then definitive radiation (6600 to 7600 cGy), or to conventional laryngectomy plus postoperative radiation. Tumour response was assessed after two cycles; responders received a third cycle. Patients with no response, or with a local recurrence after chemotherapy and radiation, underwent salvage laryngectomy. Median follow-up 33 months.
- Arms
- Induction chemotherapy plus radiation (experimental): Cisplatin plus fluorouracil (three cycles if responding after two), then definitive radiation (6600 to 7600 cGy); salvage laryngectomy for non-response or recurrence
- Laryngectomy plus radiation (control): Conventional laryngectomy followed by postoperative radiation therapy
- People
- Department of Veterans Affairs Laryngeal Cancer Study Group
Δ 24-month OS0 points
Show the numbers
| Endpoint | Analysis | Induction chemotherapy plus radiation | Laryngectomy plus radiation | Effect |
|---|---|---|---|---|
| OSRandomised patients; analysis population not stated in the abstract | interimmedian follow-up 33 monthsDepartment 1991 | 68% at 2 y | 68% at 2 y | P=0.9846The abstract gives a single estimate of 68% with a 95% CI of 60 to 76 percent for both groups; the interval is not attributed to an arm. The abstract calls the findings preliminary. |
| Larynx preservationPatients assigned to induction chemotherapy plus radiation (the abstract states 'overall' and does not name the denominator) | interimmedian follow-up 33 monthsDepartment 1991 | 64% | — | 59 patients (36%) in the chemotherapy group needed total laryngectomy. The same 64% is stated for patients alive and free of disease. |
| Endpoint | Analysis | Induction chemotherapy plus radiation | Laryngectomy plus radiation | Effect |
|---|---|---|---|---|
| OSRandomised patients; analysis population not stated in the abstract | interimmedian follow-up 33 monthsDepartment 1991 | 68% at 2 y | 68% at 2 y | P=0.9846The abstract gives a single estimate of 68% with a 95% CI of 60 to 76 percent for both groups; the interval is not attributed to an arm. The abstract calls the findings preliminary. |
| Larynx preservationPatients assigned to induction chemotherapy plus radiation (the abstract states 'overall' and does not name the denominator) | interimmedian follow-up 33 monthsDepartment 1991 | 64% | — | 59 patients (36%) in the chemotherapy group needed total laryngectomy. The same 64% is stated for patients alive and free of disease. |