DOES SUBSTITUTION OF SURGERY WITH INDUCTION CHEMOTHERAPY PRESERVE ORGAN FUNCTION IN INOPERABLE HEAD AND NECK-CANCER - A RETROSPECTIVE ANALYSIS OF 73 CASES

From August, 1984 until May, 1991, 154 patients with locally advanced head and neck cancer were treated with 3 cycles of platinum-containing induction chemotherapy followed by definitive radiotherapy. Among the m, there were 32 patients with cancer of oropharynx or hypopharynx and 41 patients with cancer of larynx, who were treated with this combine d approach with the intention of preserving the involved organ. After the completion of chemotherapy 5 (16%) patients with pharyngeal tumors achieved a complete response (CR) and 14 (44%) a partial response (PR ). After the completion of radiotherapy the CR rate was increased to 3 8%. After induction chemotherapy 7 (17%) of the 41 patients with cance r of the larynx achieved a CR and 25 (61%) a PR. The CR rate was tripl ed (68%) following radiotherapy and salvage surgery. So far, 8 complet e responders with pharyngeal and 6 with laryngeal tumors relapsed main ly locoregionally. With a minimum follow-up of 22 months, median time to progression was 8 months for patients with cancer of the pharynx an d 13 months for patients with cancer of the larynx. Median survival fo r these two groups of patients was 13 and 24 months respectively. In p atients with locally advanced cancer of the oropharynx, hypopharynx or larynx induction chemotherapy followed by radiotherapy may delay in m any or even omit in a few patients the necessity of radical surgery wi thout compromising survival.