[Organ preservation in laryngeal and hypopharyngeal cancer]

Abstract

Organ preservation in advanced laryngeal and hypopharyngeal squamous cell carcinoma has been a major target for clinical research in the last years. For a long time, partial surgery and radiotherapy were the only options that could preserve the larynx. Partial surgery has developed new open techniques and, with the introduction of laser it continues to have a clear role in organ preservation. Radiotherapy seeks better results with the use of altered fractions. But, the real revolution began after 1980 with the introduction of chemotherapy that increased the options. Induction chemotherapy followed by radiotherapy where response is good has allowed the larynx to be preserved in about half of the cases, without jeopardizing survival. Concomitant chemoradiotherapy gives better results in preservation, and induction chemotherapy followed by concomitant chemoradiotherapy is under clinical research. Finally, new targeted treatments open up new fields in clinical research. With so many options and in view of the lack of a global agreement, more multidisciplinary clinical research is still needed in order to define the best strategy for each patient.