Larynx preservation treatments result in low instance of severe voice disability, nutritional dysfunction

Head and neck cancer patients receiving induction chemotherapy followed by radiation to preserve their larynx have a low-risk of severe voice disability and almost half experienced no eating or swallowing problems, according to a first of its kind study presented at the Multidisciplinary Head and Neck Cancer Symposium.

Total larynx removal with permanent tracheotomy is the current standard treatment for patients with cancer of the larynx. While larynx preservation using chemotherapy followed by radiation is an effective treatment, the functional results are often not reported and the quality of life for these patients unknown.

Researchers at the Hopital Bretonneau in Tours, France, the Centre Hospitalier in Lorient, France, the Centre Paul Papin in Angers, France, the Institut Gustave Roussy in Villejuif, France, and the Institut Sainte Catherine in Avignon, France, observed 213 patients who received induction chemotherapy using Ciplatin and 5FU without (PF) or with Docetaxel (TPF) followed by radiation and evaluated the quality of the voice, the nutritional function and the quality of life.

After 61 months of follow up, the laryngo-esophageal dysfunction free-survival was 28 percent when averaging the PF arm and the TPF arm. Voice disability was low for 57 percent of patients, with only 15 percent experiencing severe voice disability. Forty percent of patients had no eating or swallowing problems at all and 8 percent required a feeding tube.

"For cancer patients receiving treatment to their larynx, it is important to preserve the organ, but it is more important to preserve the function of this organ," Gilles Calais, M.D., lead author of the study and a radiation oncologist at the Hopital Bretonneau in Tours, France, said. "This is the first study that analyzes not only the preservation rate but also the preservation of the function of the larynx and the esophagus."