Larynx preservation therapy by selective radiotherapy and concomitant intra-arterial cisplatin for locally advanced laryngeal cancer

Abstract

In this study, we investigated 74 patients who received selective radiotherapy and concomitant intra-arterial low-dose cisplatin infusion （modified RADPLAT） for treatment of locally advanced laryngeal cancer. The 5-year local control and laryngo-esophageal dysfunction-free survival （LEDFS） rates were 100％ and 85％ in patients with stage T2, 89％ and 76％ in those with stage T3, and 75％ and 75％ in those with stage T4a, respectively. Toxicities categorized as ≥ Grade 3 were observed as follows: leukopenia in 11 （15％）, neutropenia in 11 （15％）, and pharyngolaryngeal mucositis in 5 patients （7％）. Among 23 patients with fixed vocal folds, normal movement was restored in 19 patients （83％）, and impaired movement persisted in 1 patient, 3 months after completion of modified RADPLAT. We observed persistent fixed vocal folds in 3 patients. The 5-year LEDFS rates were 75％ and 77％, respectively in patients with or without fixed vocal folds. This study highlights that modified RADPLAT is useful for laryngeal preservation, is associated with few serious toxicities and shows favorable survival outcomes.