MANAGEMENT OF ADVANCED STAGE OF CARCINOMA LARYNX

AIM: The aim of this study was to analyze the efficacy and safety of concurrent chemotherapy with Cisplatin, Paclitaxel and radiotherapy on survival, functional and quality of life outcomes in locally advanced carcinoma of larynx.

MATERIALS & METHODS: From June 2004 to Sep 2006, seventy four inoperable, previously untreated, histopathologically proven, locally advanced patients of carcinoma larynx were planned to be treated with radical EBRT- 56 Gy and concurrent weekly chemotherapy with Cisplatin 30 mg/m² and 5FU 400 mg/m² placed in Group A and Group B patients were given RT with concomitant chemotherapy Cisplatin30 mg/m², Paclitaxel 60 mg/m² IV weekly up to 4 weeks and after a gap of two weeks all patients were given 20 Gy by reduced field without chemotherapy in both groups .

RESULTS:   Follow up of patient was done up to September 2008. The duration of follow up was in the range of 16-18 months. Parameters studied were local control, complication, recurrence and mortality. Nearly 79% of patients of Group B had complete response after completion of one-month of treatment. Local control was better in patients of Group B.

CONCLUSION: Concomitant chemo radiation with Paclitaxel and Cisplatin would be a better choice in advanced stage of laryngeal cancer, which also provides laryngeal organ preservation together with enhanced response as well as satisfactory survivors.