Treatment method improves survival for advanced laryngeal cancer, U-M study finds

January 31, 2006

Chemotherapy and radiation can be effective at treating cancer of the larynx, or voice box, without removing the organ that controls speech and swallowing. But it doesn't work for everyone.

Researchers at the University of Michigan Comprehensive Cancer Center found that determining early into treatment which patients would benefit from the chemoradiation treatment and which would be better off having surgery led to better survival rates than typically expected for this type of cancer.

"Approximately 30 percent to 40 percent of patients with advanced laryngeal cancer will not be cured with chemotherapy and radiation. The survival rates for such patients have traditionally been poor. That's why these patients should be identified as early as possible. When we did that, we found that the survival rate for these patients was markedly improved, as was the survival rate for the group of patients who were successfully treated with chemotherapy and radiation," says study author Gregory Wolf, M.D., professor and chair of otolaryngology at the U-M Medical School.

The study appears in the Feb. 1, 2006 issue of the Journal of Clinical Oncology.

The study looked at 97 patients with advanced-stage laryngeal cancer. The larynx, or voice box, plays a role in breathing, swallowing and talking. Traditional treatment for this type of cancer has been surgery to remove the voice box or part of the voice box, leading to significant quality of life concerns.

In this study, patients began with six days of chemotherapy, after which they were examined to see whether the cancer had shrunk. Tumors shrank by more than half in three-quarters of the patients. These patients then went on to receive radiation therapy five days a week for six to seven weeks, with additional chemotherapy administered once every three weeks.

The 25 percent of patients whose cancer did not respond to the initial chemotherapy were immediately considered for surgery at that point.

Three years later, 85 percent of all the patients in the study were still alive, and 70 percent had preserved their larynx. Traditional survival rates for advanced laryngeal cancer are usually less than 60 percent. Patients in the study who had surgery early on had similar survival to the patients who had organ preservation.

"One cycle of chemotherapy can identify a group of patients whose laryngeal cancer is highly likely to be successfully treated with chemotherapy and radiation. The excellent survival rates may be a result of identifying patients earlier for surgery if they are likely to fail the chemoradiation treatment. Timely integration of surgery may be a critical component in maintaining overall survival rates that are comparable to the results of primary surgery," says study author Susan Urba, M.D., associate professor of internal medicine at the U-M Medical School.

The researchers note that patients from this study faced half the risk of dying after three years compared to previous studies in patients with less advanced laryngeal cancer. Survival rates in this study also beat other recent studies using chemoradiation to treat this type of cancer.

"By matching the appropriate treatment to the patient based on the biology of the tumor, our study showed better cure rates," Wolf says. "While there are significant quality of life benefits to avoiding laryngectomy, intensive combinations of chemotherapy and radiation have some severe long-term quality of life problems as well that would be good to avoid if you could identify those patients ahead of time for whom chemoradiation was not going to work."

An estimated 9,880 people were diagnosed with laryngeal cancer in 2005, according to the American Cancer Society. For more information about laryngeal cancer, visit or call the U-M Cancer AnswerLine at 800-865-1125.

The researchers plan a larger, randomized multicenter trial using this approach in patients with cancers of the tongue base and tonsil.
In addition to Wolf and Urba, U-M study authors were Avraham Eisbruch, M.D., professor of radiation oncology; Francis Worden, M.D., clinical assistant professor of internal medicine; Julia Lee, research associate; Carol Bradford, M.D., professor of otolaryngology; Theodoros Teknos, M.D., associate professor of otolaryngology; Douglas Chepeha, M.D., associate professor of otolaryngology; Mark Prince, M.D., assistant professor of otolaryngology; Norman Hogikyan, M.D., associate professor of otolaryngology; and Jeremy Taylor, Ph.D., professor of biostatistics at the U-M School of Public Health and of radiation oncology at the U-M Medical School.

Funding for the study was from the U-M Specialized Program of Research Excellence (SPORE) grant, the Molecular Basis of Head and Neck Cancer Therapy and the Diane and Sinabaldo Tozzi Research Fund.

Reference: Journal of Clinical Oncology, Vol. 24, No. 4, pp. 593-598

University of Michigan Health System

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to