Friday, January 30, 2009
FRIDAY, Jan. 30 (HealthDay News) -- Sequential and alternating chemotherapy and radiation are equally effective for survival and larynx preservation in patients with larynx cancer, according to an article published in the Feb. 4 issue of the Journal of the National Cancer Institute.
Jean L. Lefebvre, M.D., from the Centre Oscar Lambret in Lille, France, and colleagues randomly assigned 450 patients with resectable advanced squamous cell carcinoma of the larynx whose tumors had responded to two cycles of cisplatin and 5-fluorouracil to another two cycles followed by radiation (sequential arm), or to a total of four cycles of chemotherapy with radiation between cycles (alternating arm).
After a median follow-up of 6.5 years, the researchers found that the sequential and alternating arms had similar survival with a functional larynx (hazard ratio of death and/or event 0.85), median overall survival (4.4 versus 5.1 years, respectively), and median progression-free survival (3.0 versus 3.1 years, respectively). The sequential and alternating arms also had similar extents of grade 3 or 4 mucositis (32 versus 21 percent, respectively) and late severe edema and/or fibrosis (16 versus 11 percent, respectively), the report indicates.
"It is clear that the optimal approach for larynx preservation has still not been identified," Lefebvre and colleagues conclude. "The sequential use of more effective induction chemotherapy regimens followed by less toxic locoregional approaches is one option that urgently needs to be evaluated."
Lefebvre and two other study authors serve on the advisory boards of pharmaceutical companies.
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