[Organ preservation in advanced laryngeal/hypopharyngeal carcinoma: lessons from the DeLOS-II trial]. / Organerhalt beim fortgeschrittenen Larynx/Hypopharynxkarzinom: Erfahrungen aus der DELOS-II-Studie.
HNO
; 68(9): 648-656, 2020 Sep.
Article
en De
| MEDLINE
| ID: mdl-32468135
ABSTRACT
Patients with locoregionally advanced laryngeal and hypopharyngeal squamous cell carcinomas (LHSCC) comprise two broad groups those who are candidates for functional larynx preservation (LP) with avoidance of ablative surgery and those who are not. Currently, treatment depends on the patient's needs and wishes, the experience and recommendation of the surgeon, the philosophy of the institution, etc. The milestone VA trial established non-surgical LP in advanced LHSCC in the 1990s using induction chemotherapy (IC) with PF (cisplatin, P, plus 5fluorouracil, F) followed by irradiation (ICâ¯+ RT) as an appropriate alternative treatment to total laryngectomy (TL). Even though the findings of the VA trial were verified by the EORTC 24891 trial, a debate persists regarding the best protocol for balancing survival and laryngectomy-free survival (LFS) with acceptable late toxicity and good functional outcome. In advanced LHSCC without surgical options for larynx preservation, only ICâ¯+ RT or primary concurrent platin-based chemoradiotherapy (CRT) are accepted treatment options aiming to preserve a functional larynx. In the US, cisplatin-based CRT is exclusively recommended as the best curative protocol. With regards to long-term survival with functional organ preservation and persistently high failure rates, there is current discussion on the necessity of improving patient selection based on the current literature and the recently published data of the DeLOS-II trial.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Preservación de Órganos
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Neoplasias Hipofaríngeas
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Neoplasias Laríngeas
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Laringe
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
De
Revista:
HNO
Año:
2020
Tipo del documento:
Article