J-L Lefebvre1, G Andry2, D Chevalier3, B Luboinski4, L Collette5, L Traissac6, D de Raucourt7, J A Langendijk8. 1. Head and Neck Cancer Department, Centre Oscar Lambret, Lille, France. Electronic address: jl-lefebvre@o-lambret.fr. 2. Surgery Department, Institut Jules Bordet, Brussels, Belgium. 3. Otolaryngology Department, Centre Hospitalier Régional Claude Huriez, Lille. 4. Surgery Department, Institut Gustave Roussy, Villejuif, France. 5. Statistics Department, EORTC Headquarters, Brussels, Belgium. 6. Oto-Rhino-Laryngeology Department, Hôpital Pellegrin, Bordeaux. 7. Facial Surgery Department, Centre François Baclesse, Caen, France. 8. Department of radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: We report the 10-year results of the EORTC trial 24891 comparing a larynx-preservation approach to immediate surgery in hypopharynx and lateral epilarynx squamous cell carcinoma. MATERIAL AND METHODS:Two hundred and two patients were randomized to either the surgical approach (total laryngectomy with partial pharyngectomy and neck dissection, followed by irradiation) or to the chemotherapy arm up to three cycles of induction chemotherapy (cisplatin 100 mg/m(2) day 1 + 5-FU 1000 mg/m(2) day 1-5) followed for complete responders by irradiation and otherwise by conventional treatment. The end points were overall survival [OS, noninferiority: hazard ratio (preservation/surgery) ≤ 1.428, one-sided α = 0.05], progression-free survival (PFS) and survival with a functional larynx (SFL). RESULTS: At a median follow-up of 10.5 years on 194 eligible patients, disease evolution was seen in 54 and 49 patients in the surgery and chemotherapy arm, respectively, and 81 and 83 patients had died. The 10-year OS rate was 13.8% in the surgery arm and 13.1% in the chemotherapy arm. The 10-year PFS rates were 8.5% and 10.8%, respectively. In the chemotherapy arm, the 10-year SFL rate was 8.7%. CONCLUSION: This strategy did not compromise disease control or survival (that remained poor) and allowed more than half of the survivors to retain their larynx.
RCT Entities:
BACKGROUND: We report the 10-year results of the EORTC trial 24891 comparing a larynx-preservation approach to immediate surgery in hypopharynx and lateral epilarynx squamous cell carcinoma. MATERIAL AND METHODS: Two hundred and two patients were randomized to either the surgical approach (total laryngectomy with partial pharyngectomy and neck dissection, followed by irradiation) or to the chemotherapy arm up to three cycles of induction chemotherapy (cisplatin 100 mg/m(2) day 1 + 5-FU 1000 mg/m(2) day 1-5) followed for complete responders by irradiation and otherwise by conventional treatment. The end points were overall survival [OS, noninferiority: hazard ratio (preservation/surgery) ≤ 1.428, one-sided α = 0.05], progression-free survival (PFS) and survival with a functional larynx (SFL). RESULTS: At a median follow-up of 10.5 years on 194 eligible patients, disease evolution was seen in 54 and 49 patients in the surgery and chemotherapy arm, respectively, and 81 and 83 patients had died. The 10-year OS rate was 13.8% in the surgery arm and 13.1% in the chemotherapy arm. The 10-year PFS rates were 8.5% and 10.8%, respectively. In the chemotherapy arm, the 10-year SFL rate was 8.7%. CONCLUSION: This strategy did not compromise disease control or survival (that remained poor) and allowed more than half of the survivors to retain their larynx.
Authors: Edmond H N Pow; Dora L W Kwong; Anne S McMillan; May C M Wong; Jonathan S T Sham; Lucullus H T Leung; W Keung Leung Journal: Int J Radiat Oncol Biol Phys Date: 2006-11-15 Impact factor: 7.038
Authors: Megan E Daly; Quynh-Thu Le; Anshu K Jain; Peter G Maxim; Annie Hsu; Billy W Loo; Michael J Kaplan; Nancy J Fischbein; A Dimitrios Colevas; Harlan Pinto; Daniel T Chang Journal: Head Neck Date: 2011-01 Impact factor: 3.147
Authors: J L Lefebvre; F Rolland; M Tesselaar; E Bardet; C R Leemans; L Geoffrois; P Hupperets; L Barzan; D de Raucourt; D Chevalier; L Licitra; F Lunghi; R Stupp; D Lacombe; J Bogaerts; J C Horiot; J Bernier; J B Vermorken Journal: J Natl Cancer Inst Date: 2009-01-27 Impact factor: 13.506
Authors: Yoann Pointreau; Pascal Garaud; Sophie Chapet; Christian Sire; Claude Tuchais; Jacques Tortochaux; Sandrine Faivre; Stephane Guerrif; Marc Alfonsi; Gilles Calais Journal: J Natl Cancer Inst Date: 2009-03-24 Impact factor: 13.506
Authors: Michael K M Kam; Sing-Fai Leung; Benny Zee; Ricky M C Chau; Joyce J S Suen; Frankie Mo; Maria Lai; Rosalie Ho; Kin-yin Cheung; Brian K H Yu; Samuel K W Chiu; Peter H K Choi; Peter M L Teo; Wing-hong Kwan; Anthony T C Chan Journal: J Clin Oncol Date: 2007-11-01 Impact factor: 44.544
Authors: J F Ensley; J R Jacobs; A Weaver; J Kinzie; J Crissman; J A Kish; G Cummings; M Al-Sarraf Journal: Cancer Date: 1984-09-01 Impact factor: 6.860
Authors: A Levy; P Blanchard; S Temam; M-M Maison; F Janot; H Mirghani; F Bidault; J Guigay; A Lusinchi; J Bourhis; N Daly-Schveitzer; Y Tao Journal: Strahlenther Onkol Date: 2014-03-04 Impact factor: 3.621