Journals / Kulak Burun Boğaz ve Baş Boyun Cerrahisi / 2000 / Cilt: 8 - Sayı: 2
Induction chemotherapy in treatment of laryngeal squamous cell carcinoma
- Pages
- 135–138
- DOI
- —
Abstract
Induction chemotherapy is a relatively new treatment modality for the cancer of the larynx. In this study the authors present their experience with induction chemotherapy. The charts of 19 patients with squamous cell carcinoma of the larynx who received chemotherapy as their primary treatment modality were evaluated retrospectively. All patients, except one, had extensive lesions requiring total laryngectomy a patient with a TIN3 supraglottic cancer also received chemotherapy. 8 patients were classified as $T_4$, 5 as $T_3$, and 5 as $T_2$. The chemotheraphy consisted of 2 courses of cisplatin, 5 fluorouracil. Those who responded 50% or completely to 2 courses were given the third course, which was followed by radiation therapy. For those who responded < 50% or not at all, total laryngectomy and neck dissection was done. I patient was lost-to follow-up. 9 patients responded partially or not at all, and were operated subsequently. 7 patients responded completely and were given radiation therapy. The patient with $TIN_3$ lesion had complete response of laryngeal lesion, but no response in the neck; she received radiation therapy, and radical neck dissection was done afterwards because of lack of neck response. Another patient with a complete response relapsed 9 months after treatment and was operated. Among 8 patients with a complete response, 4 completed one-year of follow-up, 3 completed 3 years, and 1 completed 4 years. The complete response rate of the laryngeal cancer reached 44.4 % (8/18). It is the authors' opinion that patients with cancer of the larynx may be given the chance of induction chemotherapy in order to avoid laryngectomy. Longer follow-up is necessary to determine the exact ratio of patients who remain disease free to those with complete response.
Özet
İndüksiyon kemoterapisi, larinks karıseri tedavisinde veni uygulanan bir tedavi şeklidir. Bu çalışmada indüksiyon kemoterapisi ile tecrübelerimizi sunmak istiyoruz. İndüksiyon kemoterapisi verilen larinks kanserli 19 hastanın kayıtları retrospektif olarak incelenmiştir Biri hariç, tüm hastalar total larinjektomi yapılması gereken ileri lezyonu olan hastalardı TIN3 supraglottik lezyonu olan hasta da kemoterapi almıştır 8 hasta $T_4$, 5 hasta $T_3$ ve 5 hasta $T_2$ olarak degerlendirilmiştir Kemoterapi olarak 2 kür cisplatin, 5 fluorouracil verilmiştir. 2 küre <% 50 veya tam cevap veren hastalara 3. kür ve ardından radyoterapi uygulanmıştır < % 50 veya hiç cevap vermeyenler total larinjektomi+boyun diseksivonu ile tedavi edilmiştir 1 hasta takip dışı kalmıştır. 9 hasta yetersiz cevap vermiş ve ameliyat edilmiştir 7 hasta tam cevap vermiştir $TIN_3$ lezyonlu hastanın larinks lezyonu tam cevap vermis, fakat boyunda gerileme gözlenmemistir: bu hastaya önce radyoterapi uygulanmış ardından radikal boyun diseksivonu yapılmıştır Tam cevap veren bir hastaya 9 ay sonra lokal rekürrens görülmüştür ve ameliyat edilmiştir Tam cevap veren 8 hastadan, 4'ü 1 yılı 3'ü 3 yılı ve l'i 4 yılı tamamlamıştır Larinks kanserinin tam cevap oranı % 44.4 (8/18) olarak bulunmuştur Sonuç olarak, larinks kanserli hastalara total larinjektomi yapmadan önce Indüksiyon kemoterapi şansı verilmelidir. Tam cevap oranını belirlemek için daha uzun süreli takip gerektiği düşünülmüştür