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Chemotherapy Research and Practice
Volume 2012 (2012), Article ID 549170, 5 pages
http://dx.doi.org/10.1155/2012/549170
Clinical Study

Induction Chemotherapy in Locally Advanced Pharyngolaryngeal Cancers with Stridor: Is It Feasible and Safe?

1Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
2Department of Surgical Oncology, Tata Memorial Hospital, Mumbai 400012, India
3Department of Radio-Diagnosis, Tata Memorial Hospital, Mumbai 400012, India

Received 1 May 2012; Revised 5 July 2012; Accepted 6 July 2012

Academic Editor: Vassilios A. Georgoulias

Copyright © 2012 Vijay Maruti Patil et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.