We conducted a randomized study in patients with previously untreated
advanced (T3) larynx carcinoma to compare total laryngectomy followed
by radiotherapy to induction chemotherapy, followed by radiotherapy in
good responders, and by total laryngectomy plus radiotherapy in poor
responders. A total of 68 patients were included in the study, 36 in t
he induction chemotherapy group and 32 in the no chemotherapy group. 1
5 of the 36 patients in the induction chemotherapy group did not have
a laryngectomy. Survival and disease-free survival were significantly
worse in the induction chemotherapy group than in the no chemotherapy
group (P = 0.006 and P = 0.02, respectively). The 2-year survival rate
s were 69% in the induction chemotherapy group and 84% in the no chemo
therapy group. Larynx preservation for patients, selected on the basis
of having responded to induction chemotherapy, cannot be considered a
standard treatment at the present time. (C) 1998 Elsevier Science Ltd
. All rights reserved.