Competing Roads to Larynx Preservation
Mené en France sur 153 patients atteints d'un carcinome épidermoïde du larynx et de l'hypopharynx de stade III ou IV, cet essai randomisé de phase II compare, du point de vue de la préservation du larynx et de la survie globale à 18 mois, l'efficacité et la toxicité de deux protocoles thérapeutiques comportant une chimiothérapie d'induction par docétaxel-cisplatine-fluorouracile suivie d'une chimioradiothérapie à base de cisplatine ou par cetuximab
Combined modality research in laryngeal cancer has focused on the dual goals of increased survival and functional organ preservation. Competing strategies consist of induction chemotherapy as initially established in the Veterans’ Administration Larynx Preservation trial and of concomitant chemoradiotherapy. Randomized trials established the combination of cisplatin and fluorouracil (PF) as induction chemotherapy and of radiotherapy with systemic-dose cisplatin every 3 weeks as feasible and effective.1-3 More recently, the addition of
docetaxel to the PF regimen (TPF) was shown to further increase overall survival when compared with PF in a general population of patients with head and neck cancer and to allow for a higher larynx preservation rate in patients with laryngeal and hypopharyngeal cancer.4-6 Bioradiotherapy by using concurrent cetuximab was shown to be superior to single-modality radiotherapy but has not been directly compared with either induction or concurrent chemoradiotherapy, tested specifically for laryngeal cancer, or shown to further improve survival when added to cisplatin radiotherapy...
Journal of Clinical Oncology , éditorial en libre accès, 2013