Organ Preservation for Cancer of the Larynx: Current Indications and Future Directions

The optimal regimen for organ preservation for laryngeal cancer remains an area of active investigation. Multiple organ-preservation strategies have been explored, including radiation therapy alone, induction chemotherapy followed by radiation therapy, and concomitant chemoradiotherapy. Until recently, induction chemotherapy followed by radiation therapy was the standard of care for organ preservation in the United States. However, recent data from the Intergroup Trial, R 91-11 has placed concomitant chemoradiotherapy in the forefront as the standard of care for organ preservation. Newer strategies are being investigated and include the use of induction chemotherapy before concomitant chemoradiotherapy and the integration of novel biological agents. It remains to be seen whether such interventions can improve on the excellent locoregional control shown in the landmark Intergroup trial.