Induction chemotherapy in locally advanced pharyngolaryngeal cancers with stridor: is it feasible and safe?
Vijay Maruti PatilVanita NoronhaAmit JoshiVamshi MudduBhavesh PoladiaBharat ChauhanKumar PrabhashDevendra Arvind ChaukarPankaj ChatturvediGouri PantvaidyaShashikant JuvekarAnil D'cruzPublished in: Chemotherapy research and practice (2012)
Background. The standard initial management of patients with locally advanced pharyngolaryngeal presenting with stridor is tracheostomy. Tracheostomy has been shown to negatively impact cancer-related outcomes. Methods. Retrospective analysis of prospectively collected data of 9 patients, who underwent induction chemotherapy with the aim of prevention of tracheostomy. Presenting features, time to resolution of stridor, and further management are reported. Results. Eight out of 9 patient received chemotherapy within 12 hours of presentation with stridor. There were 4 patients each with primary hypopharynx and larynx. The stage was IVA in 6 patients and IVB in 2 patients. In all patients receiving immediate chemotherapy, clinical stridor resolved within 48 hours. The radiological response rate was 62.5%. The median reduction in size of tumor was 37%. Conclusion. Immediate neoadjuvant chemotherapy is a feasible and safe option for patients presenting with early stridor and helps in resolution of stridor and avoiding tracheostomy.
Keyphrases
- acute respiratory distress syndrome
- mechanical ventilation
- locally advanced
- end stage renal disease
- neoadjuvant chemotherapy
- ejection fraction
- newly diagnosed
- squamous cell carcinoma
- peritoneal dialysis
- prognostic factors
- type diabetes
- patient reported outcomes
- clinical trial
- case report
- adipose tissue
- young adults
- intensive care unit
- study protocol
- patient reported