Introduction: Chemo-radiation preceded by induction chemotherapy is reported valuable alternative to laryngectomy in laryngeal cancer for larynx preservation. This study was performed to assess the influence chemo radiation on preservation of larynx.

Materials and Methods: Sixty-three patients treated from January 2013 to December 2014 in our institute were reviewed and who were available for follow-up in this retrospective study. Total dose of 66-70 Gray was used at 2 gray per fraction daily for five days week were used. Larynx preservation rate at 1 year of median follow-up were analysed.

Results: Among 63 patients, larynx preservation was possible in 50 patients (78%). With chemo-radiation, excellent preservation of larynx was achieved in stage II (78%) disease, while in advanced stage III and stage IVA, larynx preservation was6 7.06% and 64.35%, respectively.

Conclusion: Chemo-radiation (either neoadjuvant chemotherapy followed by chemoradiation or concurrent chemo-radiation) has better larynx preservation rate in early as well was advanced laryngeal cancer patients.

1. Http://seer.cancer.gov/statfacts/html/laryn.html.
2. Ensley JF, Jacobs JR, Weaver A, Kinzie J, Crissman J, Kish JA,et al. Correlation between response to cisplatinum-combination chemotherapy and subsequent radiotherapy in previously untreated patients with advanced squamous cell cancers of the head and neck. Cancer, 1984;54:811-4.
3. The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med, 1991;324:1685-90.
4. Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl JMed, 2003;349:2091-8.
5. Pignon JP, le Maître A, Maillard E, Bourhis J. MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and17,346 patients. Radiother Oncol, 2009;92:4-14.
6. Forastiere AA, Zhang Q, Weber RS, Maor MH, Goepfert H, Pajak TF, et al. Long-term results of RTOG 91-11: A comparison of three nonsurgical treatment strategies to preserve the larynxin patients with locally advanced larynx cancer. J Clin Oncol,2013;31:845-52.
7. Corry J, Peters L, Kleid S, Rischin D. Larynx preservation for patients with locally advanced laryngeal cancer. J Clin Oncol, 2013;31:840-4.
8. Mohanty BK, Bahadur S, Lal P. Cancers of the Head and Neck. In:Rath GK, Mohanty BK, editors. Textbook of Radiation oncologyPrinciples and Practice. 1st ed. New Delhi: Elsevier; 2002;162-3.
9. Garden AS, Morrison WH. Larynx and hypopharynx cancer. In: Gunderson LL, Tepper JE, editors. Clinical Radiation Oncology.3rd ed. Philadelphia: Elsevier Saunders; 2012; 639-63.
10. Bron LP, Soldati D, Zouhair A, Ozsahin M, Brossard E, Monnier P, et al. Treatment of early stage squamous-cell carcinoma of theglottic larynx: Endoscopic surgery or cricohyoidoepiglottopexy versus radiotherapy. Head Neck, 2001;23:823-9.
11. Spector JG, Sessions DG, Chao KS, Haughey BH, Hanson JM, Simpson JR, et al. Stage I (T1 N0 M0) squamous cell carcinoma ofthe laryngeal glottis: Therapeutic results and voice preservation. Head Neck, 1999;21:707-17.
12. Verdonck-de Leeuw IM, Keus RB, Hilgers FJ, Koopmans-vanBeinum FJ, Greven AJ, De Jong JM, et al. Consequences of voice impairment in daily life for patients following radiotherapy for early glottic cancer: Voice quality, vocal function and vocalperformance. Int J Radiat Oncol Biol Phys,1999;44:1071-8.
13. Mendenhall WM, Amdur RJ, Morris CG, Hinerman RW. T1-T2N0 squamous cell carcinoma of the glottic larynx treated withradiation therapy. J ClinOncol 2001;19:4029-36.
14. Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB. Management of T1T2 glottic carcinomas. Cancer,2004;100:1786-92.
15. Richard JM, Sancho-Garnier H, Pessey JJ, Luboinski B, Lefebvre JL, Dehesdin D, et al. Randomized trial of induction chemotherapyin larynx carcinoma. Oral Oncol. 1998; 34:224-8.
16. Gregoire V, De Neve W, Eisbruch A, Lee N, Weyngaert D Van den,VanGestel D. Intensity-modulated radiation therapy for head and neck carcinoma. Oncologist. 2007; 12:555-64.

Dr Madhumathi S

Assistant Professor, Madras Medical College Chennai