In three arm study by RTOG (91-11), incidence of laryngectomy was 28% in induction (ICT) chemotherapy arm, 16% in concomitant arm, and 31% in radiation(RT) alone arm. Following TL, the incidence of major and minor complications ranged from 52% to 59% and did not differ significantly among the 3 arms. Fistula was lowest in RT alone arm (15%) and highest in concomitant arm (30%). Similar experience was reported from MSKCC with fistulas occurring in 39%, resulting in prolonged hospitalization. When compared with complication rates of surgery in untreated patients, the complication rates following unsuccessful LP protocol is significantly higher. In spite of higher morbidity, local-regional control is excellent for this group of patients. In RTOG trial, local-regional control following SS was 74% for CT arms and 90% for RT alone arm. At 24 months, the overall survival was equal in all arms.