Treatment of Laryngeal Cancer at Stage III or Stage IV
Clinical Scenario
This protocol covers initial management of laryngeal cancer presenting at stage III or stage IV — locally advanced disease that requires active, multidisciplinary treatment planning. The main options for initial treatment include surgery, chemotherapy followed by chemoradiation, or chemotherapy with radiation.
Treatment Approach
Initial management may involve surgical approaches, radiation-based strategies, or immunotherapy, with the specific pathway determined by disease extent and patient factors — the full regimen and eligibility criteria are in the complete protocol.
Treatment Goals
Key markers of response include tumor shrinkage following induction chemotherapy and absence of remaining cancer after chemoradiation.
References
- The main options for initial treatment for these cancers are surgery, chemotherapy followed by chemoradiation, or chemotherapy with radiation.
- Radiation therapy alone (or with the targeted drug cetuximab) may be an option for people who cannot tolerate more intensive treatments.
- Immunotherapy might be another option for some people.
- Surgery for these tumors is almost always complete removal of the larynx (total laryngectomy), but a small number of these cancers might be treated by partial laryngectomy.
- If surgery is planned, immunotherapy with a drug called a checkpoint inhibitor might be given both before and after surgery.
- Another option may be to start with just chemotherapy, which is called induction chemotherapy.
- If the tumor shrinks, radiation therapy or chemoradiation is then given.
- If any cancer remains after treatment, surgery can then be done to try to remove it.
View source ↗