Notable Trials

Question 1

Discuss the study design of VA larynx trial.

Answer 1

Stage III laryngeal cancer patients to total laryngectomy + post-op RT vs sequential RT (induction chemo (cis/5-FU) followed by RT)

Question 2

What were the results of the VA larynx trial?

Answer 2

At 2 yrs, OS was the same ~ 68% between total laryngectomy + post-op RT vs sequential RT (induction chemo (cis/5-FU) followed by RT

Question 3

What was the overall larynx preservation rate?

Answer 3

64% in the chemoRT arm

Question 4

Discuss the study design of RTOG 9111.

Answer 4

Phase III trial randomized of 547 patients with stage III cancers of the glottis and supraglottis.

Three arms:
Arm 1 - Induction chemo (cis/5-FU) followed by XRT (or laryngectomy if poor response plus adjuvant RT to 50-70 Gy depending on surgical margin status)

Arm 2 - Concurrent cisplatin and RT

Arm 3 - RT alone (70 Gy in 35 fx)

Question 5

What are the results of RTOG 9111?

Answer 5

No OS difference between the three arms.

Question 6

What was the larynx preservation rate in RTOG 91111?

Answer 6

Improved with concurrent chemoRT arm vs. the induction arm (HR 0.58, P= 0.005)

Question 7

What was the larynx preservation rate in RTOG 91111 between induction chemoRT arm vs. XRT alone arm?

Answer 7

Larynx preservation was similar between the induction chemoRT arm and XRT alone arm.

Question 8

What was the 5 yr larynx preservation rate in the chemoRT arm of RTOG 9111?

Answer 8

84%