***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: PURPOSE To determine overall survival , progression-free survival , rate of voice preservation , and patterns of failure in locoregionally advanced laryngeal cancer treated with induction chemotherapy with or without surgery followed by concomitant chemoradiation . BACKGROUND Locoregionally advanced laryngeal cancer has been conventionally treated with either surgery and adjuvant radiotherapy or radiotherapy alone , and clinical and functional outcomes have been poor . Chemoradiotherapy has been demonstrated to improve functional outcome and disease control over conventional treatment in recent r and omized head and neck trials . PATIENTS AND METHODS Advanced head and neck cancer patients were enrolled onto two consecutive phase II studies . Induction treatment consisted of three cycles of cisplatin , 5-fluorouracil ( 5-FU ) , leucovorin , and interferon-alpha 2b ( PFL-IFN ) followed by surgery for residual disease . Surgical intent was to spare the larynx when possible . All patients then proceeded to concomitant chemoradiation consisting of seven or eight cycles of 5-FU , hydroxyurea , and a planned total radiotherapy dose of 7000 cGy ( FHX ) . RESULTS A subset of thirty-two laryngeal cancer patients with predominantly stage IV disease comprises the study group for this report . Clinical CR was observed in 59 % of patients following induction therapy . The median follow-up was 63.0 months for surviving patients and 44.5 months for all patients . At five years , overall survival is 47 % , progression-free survival is 78 % , and locoregional control is 78 % . No distant failures were observed . Voice preservation with disease control was 75 % at five years . Only two total laryngectomies were performed during the course of treatment and follow-up . Treatment-related toxicity accounted for two deaths . CONCLUSIONS The addition of concomitant chemoradiotherapy to induction chemotherapy for locoregionally advanced laryngeal cancer appears to increase locoregional control and survival rates . PFL-IFN-FHX result ed in high rates of disease cure and voice preservation in a group of patients that has traditionally fared poorly in both clinical and functional outcome PURPOSE Taxane-based concurrent chemoradiotherapy ( CCR ) for head and neck cancers has proven to have a favorable toxicity profile compared with cisplatin and radiation . This phase II multi-institutional trial evaluates taxane-based induction chemotherapy followed by CCR for organ preservation in resectable stage III/IVA and IVB larynx and oropharynx ( OP ) cancer patients . PATIENTS AND METHODS Eligibility required resectable stage T2N+ , or T3-T4N0 - 3M0 biopsy-proven squamous carcinoma , age at least 18 years , PS 0 to 2 , good organ function , and no prior chemotherapy or radiation .  Treatment was induction paclitaxel 175 mg/m(2 ) and carboplatin area under the concentration-time curve ( AUC ) 6 for two cycles every 21 days followed by concurrent paclitaxel 30 mg/m(2 ) every 7 days with 70 Gy if no evidence of tumor progression . Weekly erythropoietin alpha 40 kU was used for suboptimal hemoglobin ( < 14 gm/dL men , < 13 gm/dL women ) . The primary end point was organ preservation ( freedom from primary site salvage surgery or primary tumor recurrence ) . RESULTS One hundred five of 111 patients ( 36 larynx , 69 OP ) were eligible . Median follow-up was 36.7 months . Ninety-four percent received full-dose radiotherapy and 91 % received at least five cycles of concurrent paclitaxel . No patient progressed while receiving chemotherapy .  Organ preservation was 81 % at 2 years after completion of therapy ( larynx 74 % , OP 84 % ) . Thirteen patients required primary -site salvage surgery ( seven larynx , six OP ) , and six of these have progressed and died ( three larynx , three OP ) . Thirteen patients developed distant metastases ( seven larynx , six OP ; P = .02 ) and 10 of 36 larynx and 11 of 69 OP patients have died as a result of their disease . Two-year survival is 76 % ( 63 % larynx v 83 % OP ) . CONCLUSION A high organ preservation rate was obtained with this regimen for OP but not for larynx patients . Toxicity was low , and induction chemotherapy did not preclude delivery of concurrent chemoradiotherapy PURPOSE The efficacy and toxicity of neoadjuvant chemotherapy followed by radiotherapy and concurrent chemoradiotherapy and their impact on larynx preservation have been studied in patients with advanced ( stage III , IVa , and IVb ) squamous cell cancer of the larynx . PATIENTS AND METHODS Fifty patients were treated with either 2 - 4 cycles of induction chemotherapy with cisplatin 100 mg/m(2 ) , day 1 and infusional 5-fluorouracil ( 5-FU 1000 mg/m(2 ) , days 1 - 5 ) , followed by radiotherapy 70 Gy , 1.8 - 2 Gy per fraction , or concurrent chemoradiotherapy ( the above-mentioned radiotherapy concurrently with carboplatin 300 mg/m(2 ) every 21 days or weekly paclitaxel 80 mg/m(2 ) ) . Patients were allocated in the 2 arms by 1:1 selection . At the end of both protocol s , patients without complete response ( CR ) underwent laryngectomy and /or neck lymph node dissection . Assessed were response and toxicity rates , overall survival ( OS ) and disease-free survival ( DFS ) . RESULTS A total of 31 ( 62 % ) patients achieved larynx preservation with acceptable organ function . No statistically significant difference in response rate and OS was found between the two treatment arms . Patients su bmi tted to concurrent chemoradiotherapy showed significantly longer DFS ( 14 vs. 10 months , p= 0.0397 ) and higher rates of larynx preservation ( p < 0.05 ) . All grade IV side effects occurred in the concurrent chemoradiotherapy group . CONCLUSION Concurrent compared to alternating chemoradiotherapy was more toxic , but achieved significantly longer DFS and higher rate of larynx preservation BACKGROUND Locally advanced laryngeal and hypopharyngeal cancers ( LHC ) represent a group of cancers for which surgery , laryngectomy-free survival ( LFS ) , overall survival ( OS ) , and progression-free survival ( PFS ) are clinical ly meaningful end points . PATIENTS AND METHODS These outcomes were analyzed in the subgroup of assessable LHC patients enrolled in TAX 324 , a phase III trial of sequential therapy comparing docetaxel plus cisplatin and fluorouracil ( TPF ) against cisplatin and fluorouracil ( PF ) , followed by chemoradiotherapy . RESULTS Among 501 patients enrolled in TAX 324 , 166 had LHC ( TPF , n = 90 ; PF , n = 76 ) . Patient characteristics were similar between subgroups . Median OS for TPF was 59 months [ 95 % confidence interval ( CI ) : 31-not reached ] versus 24 months ( 95 % CI : 13 - 42 ) for PF [ hazard ratio ( HR ) for death : 0.62 ; 95 % CI : 0.41 - 0.94 ; P = 0.024 ] . Median PFS for TPF was 21 months ( 95 % CI : 12 - 59 ) versus 11 months ( 95 % CI : 8 - 14 ) for PF ( HR : 0.66 ; 95 % CI : 0.45 - 0.97 ; P = 0.032 ) . Among operable patients ( TPF , n = 67 ; PF , n = 56 ) , LFS was significantly greater with TPF ( HR : 0.59 ; 95 % CI : 0.37 - 0.95 ; P = 0.030 ) . Three-year LFS with TPF was 52 % versus 32 % for PF . Fewer TPF patients had surgery ( 22 % versus 42 % ; P = 0.030 ) . CONCLUSIONS In locally advanced LHC , sequential therapy with induction TPF significantly improved survival and PFS versus PF . Among operable patients , TPF also significantly improved LFS and PFS . These results support the use of sequential TPF followed by carboplatin chemoradiotherapy as a treatment option for organ preservation or to improve survival in locally advanced LHC BACKGROUND We performed a prospect i ve , r and omized study in patients with previously untreated advanced ( Stage III or IV ) laryngeal squamous carcinoma to compare the results of induction chemotherapy followed by definitive radiation therapy with those of conventional laryngectomy and postoperative radiation . METHODS Three hundred thirty-two patients were r and omly assigned to receive either three cycles of chemotherapy ( cisplatin and fluorouracil ) and radiation therapy or surgery and radiation therapy . The clinical tumor response was assessed after two cycles of chemotherapy , and patients with a response received a third cycle followed by definitive radiation therapy ( 6600 to 7600 cGy ) . Patients in whom ther was no tumor response or who had locally recurrent cancers after chemotherapy and radiation therapy underwent salvage laryngectomy .  RESULTS After two cycles of chemotherapy , the clinical tumor response was complete in 31 percent of the patients and partial in 54 percent . After a median follow-up of 33 months , the estimated 2-year survival was 68 percent ( 95 percent confidence interval , 60 to 76 percent ) for both treatment groups ( P = 0.9846 ) . Patterns of recurrence differed significantly between the two groups , with more local recurrences ( P = 0.0005 ) and fewer distant metastases ( P = 0.016 ) in the chemotherapy group than in the surgery group . A total of 59 patients in the chemotherapy group ( 36 percent ) required total laryngectomy . The larynx was preserved in 64 percent of the patients overall and 64 percent of the patients who were alive and free of disease . CONCLUSIONS These preliminary results suggest a new role for chemotherapy in patients with advanced laryngeal cancer and indicate that a treatment strategy involving induction chemotherapy and definitive radiation therapy can be effective in preserving the larynx in a high percentage of patients , without compromising overall survival AIM Survival in head and neck cancers reflect loco-regional control . With an aim of organ and function preservation the present study was undertaken to compare local failure and survivals . MATERIAL AND METHODS Between August 1991-December 1995 , 72 patients with resectable advanced supraglottic cancers , were r and omized to radical surgery followed by post-operative radiation therapy ( Sx+PORT ) ( Arm I ) or radical radiation therapy followed by salvage surgery ( RRT+/-SSx ) ( Arm II ) . RESULTS Sixty-four of 72 patients were evaluable , 55 were T3 ( 86 % ) and 9 were T4 ( 14 % ) tumors . In Arm I ( n=35 ) with a mean follow-up of 24 months ( 2 - 86 months ) , 21 patients were alive without disease . Six patients had recurrence , one each at local and tracheostomy stoma , four had nodal recurrence only , and two developed 2nd primary in soft palate/tonsil and parotid at 15 and 18 months respectively . In Arm II ( n=29 ) , with a mean follow-up of 24 months ( 3 - 81 months ) , 14 patients were alive without disease . Thirteen patients had recurrence , eight had local ( one patient had persistent disease ) , two nodal only , three loco-regional and two patients developed distant metastasis ( lung ) . One out of eight local recurrence and 2/2 nodal recurrences were salvaged with Sx . There was a significant difference in disease-free survival between the two treatment arms , DFS ( 5 years ) of 70 % in Arm I vs 50 % in Arm II ( p=0.04 ) , but did not have any impact on overall survival OAS ( 5 years ) ; 73 % vs 77 % ( p=0.79 ) . Voice/laryngeal preservation was possible in 18/29 patients ( 62 % ) treated with RRT+/- Sx , without significantly affecting the OAS . " Pathological upstaging " was another significant finding seen in 64 % of clinical T3 after radical surgery . CONCLUSION RRT+/-SSx can be a feasible option in low volume , favourable resectable stage III and IV supraglottic lesions for better quality of life BACKGROUND AND PURPOSE To compare in a phase III study the loco-regional control , disease-free survival and overall survival induced by an accelerated regimen ( AF ) as compared with conventional regimen ( CF ) and to analyze the early and late post-radiation morbidity in both arms . MATERIAL S AND METHODS Patients with age < or = 75 , WHO 0 - 1 , suitable for a radical course of radiotherapy T1-T3 , N0 , M0 , stage of glottic and supraglottic laryngeal cancer were r and omized to either CF : 66Gy given in 33 fractions over 45 days or 
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Conclusion These findings suggest that of the larynx-preserving treatments , RT alone was associated with highest rates of OS , DFS , and LFS in patients with locally advanced cancer of the larynx and hypopharynx .
Laryngectomy provided a better rate of DFS than CT and RT , but OS were similar across the different larynx-preserving treatments and laryngectomy