Definitive Chemoradiotherapy versus Surgery Followed by Adjuvant Radiotherapy in Resectable Stage III/IV XXXX .

@entity1 @entity67888 @entity137 @entity5 @entity957
Purpose: The purpose of this study is to compare the treatment outcomes for locally advanced resectable @entity5 between organ-preserving chemoradiotherapy (CRT) and surgery followed by radiotherapy (SRT). Materials and Methods: We reviewed 91 @entity1 with stage III/IV @entity957 treated with radiotherapy. In the CRT group (n=34), 18 @entity1 were treated with concurrent CRT and 16 @entity1 with induction chemotherapy plus concurrent CRT. In the SRT group (n=57), 6 patents were treated with total laryngopharyngectomy (TLP), 34 @entity1 with total laryngectomy and partial pharyngectomy ( @entity67888 /PP), and 17 @entity1 with partial pharyngectomy (PP), which were followed by adjuvant RT (n=41) or CRT (n=16). The median RT dose was 70 Gy for CRT and 59.4 Gy for SRT. Results: Five-year local control (84.1% vs. 90.9%), and disease-free (DFS: 51.0% vs. 52.7%) and overall survival (OS: 58.6% vs. 56.6%) showed no significant difference between the CRT and SRT groups. The functional larynx-preservation rate was higher in the CRT group (88.2% vs. 29.8%). Treatment-related @entity137 , requiring surgical intervention, occurred more frequently in the SRT group (37% vs. 12%). In the SRT group, @entity67888 resulted in a significantly higher DFS than larynx-sparing surgery (63.9% vs. 26.5%, p = 0.027). Treatment outcome of the SRT group improved when only @entity1 with @entity67888 were considered (n = 40); however, 5-year OS (67.1% vs. 58.6%, p = 0.830) and DFS (63.9% vs. 51.0%, p = 0.490) did not improve significantly when compared to the CRT group. Conclusion: Organ preserving CRT provided a treatment outcome that is comparable to SRT for locally advanced @entity5 , while offering an opportunity for functional larynx-preservation and reduced treatment-related @entity137 .
