new YORK (Reuters Health) – the latest information of a

clinical trial that began in 1992 confirms that with the use of

chemotherapy sequential and concomitant to treat cancer of

Advanced larynx are locally obtained similar results in

survival of patients, but that the concomitant focus

is that most protects the larynx.

when the RTOG 91-11 study results were published

for the first time in 2003, “changed the treatment

standardized to protect the larynx which passed the use

sequential chemotherapy followed by radiotherapy to the

joint application of both therapies”, said by e-mail the

main author, Dr. Arlene Forastiere, Johns Hopkins

University.

“results were kept during the last decade

– added-(…) and the same treatment continues to be the focus

standardized” “zorg, 15 procent van de patiënten zal

moet een laryngectomie met de daarmee gepaard gaande, benadering

in vergelijking met dubbele, of 30 procent, als u

chemotherapie en radiotherapie van opeenvolgend of radiotherapie

alleen.”

aan Dr. Chris Holsinger, hoofd kanker chirurg

en de staart van het centrum van oncologie in MD Anderson, Houston, Texas, en

die niet deelnemen aan de studie, “lijdt geen twijfel dat East

studie veranderd de manier waarop we concentreren en daarmee omgaan

ziekte, dus het is echt een studie van de verwijzing”.

tussen 1992 en 2000, 547 patiënten geïntegreerd drie willekeurige

groepen: een inductie gevolgd door chemotherapie van ontvangen

radiotherapie; another received concomitant radiotherapy chemo, and

third received radiotherapy only.

the first group received up to three cycles of 100 mg/m2 of

cisplatin daily of fluorouracil 1000 mg/m2 and the first day

for five days, every three weeks. patients who

responded to these regimes, they received up to 70 Gy of

radiotherapy in 35 treatments in fractions of 2 Gy.

,

the group treated with concomitant approach received 100 mg/m2

cisplatin days 1, 22 and 43 of radiotherapy.

the group treated only with radiation therapy received 70 Gy of

radiation.

all participants had squamous cell cancer in

stage III or IV (glottic or supraglottic cancer) considered

curable with a laryngectomy and radiotherapy. the result

primary was “survival without laryngectomy”, which was evaluated

< p> na een gemiddelde van 10,8 jaar van follow-up in dit stadium

toxiciteit evalueerden ook in de studie. laat.

de vijf en tien jaar overleven verschilt niet

aanzienlijk tussen groepen; fue de entre 54-58 por

ciento y 28-39 por ciento, respectively.

Tampoco hubo una permitteert significativa nl la incidencia

acumulativa de las toxicidades de grado 3-5. een los 10 años, los

resultados fueron del 30,6 por ciento para la quimioterapia de

inducción seguida de radioterapia, del 33,3 por ciento para la

quimio radioterapia concomitante y del 38 por ciento para la

radioterapia solamente.

De todos modos, nl cuando een la preservación de la laringe, el

equipo detectó una ventaja significativa con el uso concomitante

de cisplatino y radioterapia (se redujo un 54 por ciento el

riesgo relativo de necesitar una laringectomía con respect del

uso de radioterapia y un 42 por ciento con respect de la

quimioterapia de inducción más radioterapia).

Este estudio es uno de los más grandes y prolongados Engelse este

campo. But the head and neck cancer is a disease

homogeneous. “do not have a standard established for the

head and neck in general and larynx cancers in

particular”, said Jochen Lorch, of the Institute of Oncology

Dana-Farber, Boston, and did not participate in the study.

“believe that this study shows the value of both

approaches, that of induction and the concomitant, but I think that not

get a definitive answer about what is best for

treat this disease – said Holsinger-. these different

approaches open a way to the study of surgery minimally

invasive for this disease, especially approaches

neoadjuvant.”

complete results of the study are published in the Journal of

Clinical Oncology.

source: Journal of Clinical Oncology, online November 26

< p> 2012