***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Our objectives were to determine the incidence of acute and late toxicities and to estimate the 2-year overall survival for patients treated with reirradiation and chemotherapy for unresectable squamous cell carcinoma of the head and neck ( SCCHN ) . METHODS Patients with recurrent squamous cell carcinoma or a second primary arising in a previously irradiated field were eligible . Four weekly cycles of 5-fluorouracil 300 mg/m2 IV bolus and hydroxyurea 1.5 g by mouth were used with 60 Gy at 1.5 Gy twice-daily fractions . Toxicity was scored according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer ( RTOG/EORTC ) criteria . RESULTS Seventy-nine of the 86 patients enrolled were analyzable . The worst acute toxicity was grade 4 in 17.7 % and grade 5 in 7.6 % . Grade 3 and 4 late toxicities were found in 19.4 % and 3.0 % , respectively . The estimated cumulative incidence of grade 3 to 4 late effects occurring at > 1 year was 9.4 % ( 95 % confidence interval [ CI ] : 0 , 19.7 ) at 2 and 5 years . The 2- and 5-year cumulative incidence for grade 4 toxicity was 3.1 % ( 95 % CI : 0 , 9.3 ) . The estimated 2- and 5-year survival rates were 15.2 % ( 95 % CI : 7.3 , 23.1 ) and 3.8 % ( 95 % CI : 0.8 , 8.0 ) , respectively . Patients who entered the study at > 1 year from initial radiotherapy ( RT ) had better survival than did those who were < 1 year from prior RT ( median survival , 9.8 months vs 5.8 months ; p = .036 ) . No correlation was detected between dose received and overall survival . Three patients were alive at 5 years . CONCLUSION This is the first prospect i ve multi-institutional trial testing reirradiation plus chemotherapy for recurrent or second SCCHN . The approach is feasible with acceptable acute and late effects . The results serve as a benchmark for ongoing RTOG trials BACKGROUND The purpose of this study was to evaluate long-term outcomes after induction chemotherapy followed by " risk-based " local therapy for locally-advanced squamous cell carcinoma of the head and neck ( SCCHN ) . METHODS Forty-seven patients ( stage IV ; ≥N2b ) were enrolled in a phase II trial . Baseline and 24-month functional measures included modified barium swallow ( MBS ) studies , oropharyngeal swallow efficiency ( OPSE ) , and the MD And erson Dysphagia Inventory ( MDADI ) . Functional status was assessed at 5 years . RESULTS Five-year overall survival ( OS ) was 89 % ( 95 % confidence interval [ CI ] , 81 % to 99 % ) . A nonsignificant 13 % average reduction in swallowing efficiency ( OPSE ) was observed at 24 months relative to baseline ( p = .191 ) . MDADI scores approximated baseline at 24 months . Among 42 long-term survivors ( median , 5.9 years ) , 3 patients ( 7.1 % ) had chronic dysphagia . The rate of final gastrostomy dependence was 4.8 % ( 2 of 42 ) . CONCLUSION Sequential chemoradiotherapy achieved favorable outcomes among patients with locally advanced SCCHN , mainly of oropharyngeal origin . MBS and MDADI scores found modest swallowing deterioration at 2 years , and chronic aspiration was uncommon in long-term survivors BACKGROUND The purpose of this study was to analyse the results of salvage surgery after failure of irradiation to control the primary T1-T2 glottic cancer . MATERIAL S AND METHODS Ninety-eight patients with T1 and T2 squamous cell cancer of the glottic larynx were treated with curative intent by radiotherapy . The tumour recurred in 22 of the 98 ( 22 % ) patients . Surgical management consisted of total and frontolateral laryngectomy .  Survival rates were calculated from the date of the salvage operation . RESULTS Two of the 22 patients refused to undergo salvage surgery and one patient had pulmonary metastasis . Of the 19 patients who underwent salvage surgery , 14 ( 74 % ) had total laryngectomy and 5 ( 26 % ) had frontolateral laryngectomy . The operations were curative in 15 ( 79 % ) of the 19 patients . The overall 5-year survival rate after surgery was 78 % . CONCLUSION Stringent follow-up of patients with irradiated T1 and T2 glottic laryngeal cancer is essential to permit a successful salvage OBJECTIVES To determine the incidence of local control in patients with " advanced " moderately to well-differentiated endolaryngeal invasive squamous cell carcinoma classified as T3 , treated with a supracricoid partial laryngectomy  ; to identify any statistical relationship ; and to analyze the consequences of local recurrence . DESIGN Retrospective nonr and omized case series . SETTING A tertiary referral care center and university teaching hospital . PATIENTS An inception cohort of 118 patients . Tumor stage was T3 N0 M0 in 90 patients , T3 N1 M0 in 21 patients , T3 N2 M0 in 5 patients , and T3 N3 M0 in 2 patients . INTERVENTIONS All patients underwent supracricoid partial laryngectomy .  A platin-based induction chemotherapy regimen was used in 100 patients . Postoperative radiotherapy was used for 24 patients . MAIN OUTCOME MEASURES Local recurrence , nodal recurrence , distant metastasis , and survival ; univariate and multivariate analysis of local recurrence . RESULTS Nine patients developed a local recurrence . The 1- , 3- , and 5-year actuarial local control estimates were 97.3 % , 93.5 % , and 91.4 % , respectively . In a stepwise regression model , the presence of positive margins of resection was the only variable that statistically increased the risk of local recurrence ( P = .008 ) . Local recurrence result ed in a significant increase in nodal recurrence ( P<.001 ) and distant metastasis ( P<.001 ) and a significant decrease in survival ( P = .03 ) . An overall 89.8 % laryngeal preservation rate and 98.3 % local control rate were achieved . CONCLUSION Supracricoid partial laryngectomies should be considered when an organ preservation strategy is discussed in patients with advanced endolaryngeal squamous cell carcinoma classified as T3 OBJECTIVES /HYPOTHESES Study 1 : To assess the oncologic outcome following  supracricoid partial laryngectomy ( SCPL ) . Study 2 : To compare the quality of life ( QOL ) following SCPL to total laryngectomy ( TL ) with tracheoesophageal puncture ( TEP ) . Study 3 : To analyze whole organ TL sections to determine the percentage of lesions amenable to SCPL STUDY DESIGN : Study 1 : A retrospective review of patients who underwent SCPL .  Study 2 : A non-r and omized , prospect i ve study using QOL instruments to compare patients who underwent either  SCPL or TL  Study 3 : A retrospective histopathologic study of TL specimens assessed for the possibility of performing an SCPL . METHODS Study 1 : Twenty-five patients with carcinoma of the larynx underwent SCPL between June 1992 and June 1999 . Various rates of oncologic outcome were calculated . Study 2 : Thirty-one patients participated in the QOL assessment . This included the SF-36 general health status measure , the University of Michigan Head and Neck Quality of Life ( HNQOL ) instrument , and the University of Michigan Voice-Related Quality of Life ( VRQOL ) instrument . Study 3 : Ninety surgical specimens were obtained and studied from the total laryngectomy cases in the Tucker Collection . Multiple sites were evaluated for the presence of carcinoma A computer program was written to classify whether the patient was amenable to SCPL . RESULTS Study 1 : The overall local control rate was 96 % ( 24/25 ) . The local control rate following SCPL with cricohyoidoepiglottopexy ( CHEP ) was 95 % ( 20/21 ) . The local control rate following SCPL with cricohyoidopexy ( CHP ) was 100 % ( 4/4 ) . Study 2 : The SCPL had significantly higher domain scores than TL and TEP in the following categories for the SF-36 : physical function , physical limitations , general health , vitality , social functioning , emotional limitations , and physical health summary . The significantly higher domains for the SCPL when compared with the TL and TEP for the HNQOL were eating and pain . Finally , when voice-related QOL was assessed with the V-RQOL , the domains of physical functioning and the total score were significantly better with SCPL when compared with TL and TEP . Study 3 : Forty of 90 ( 44 % ) laryngeal whole organ specimens were determined to be resectable by SCPL . In 16 ( 18 % ) specimens , the patients could have undergone SCPL with CHEP and in 24 ( 27 % ) specimens the patients could have undergone SCPL with CHP . Among the 40 ( 44 % ) specimens determined to be able to have undergone SCPL , 19 were glottic ( 1 T1 , 15 T2 , 3 T3 ) and 21 were supraglottic ( 9 T2 , 12 T3 ) . CONCLUSIONS 1 ) A review of the literature and an analysis of the data in this study indicate that excellent local control may be expected following SCPL . 2 ) The QOL following SCPL , as measured by three vali date d QOL instruments , is superior to TL with TEP . 3 ) A histologic assessment of whole organ sections of TL specimens indicates that many patients who have been subjected to TL may have been c and i date s for SCPL . 4 ) If the indications and contraindications are rigorously adhered to , SCPLs are reasonable alternatives to TL in selected cases 
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We therefore hypothesised that careful assessment of tumour extension might be responsible for the high 5-year OS and 5-year DFS .