# RTOG 91-11

Source: https://onco.cc/trials/rtog-91-11/  
OnCo record `rtog-91-11` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

RTOG 91-11 established concurrent cisplatin with radiotherapy as the way to keep the voice box in advanced larynx cancer: more patients kept their larynx than with induction chemotherapy or radiotherapy alone, with no loss of survival.

## Summary

RTOG 91-11 randomised 547 patients with stage III or IV larynx cancer to induction cisplatin-fluorouracil followed by radiotherapy, concurrent cisplatin with radiotherapy, or radiotherapy alone. At two years the larynx was preserved in 88 percent with concurrent chemoradiation, 75 percent with induction and 70 percent with radiotherapy alone; locoregional control was best with concurrent treatment and overall survival did not differ (Forastiere and colleagues, New England Journal of Medicine 2003). Long-term follow-up showed more non-cancer deaths after concurrent treatment, a caution about late toxicity.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-17
- Tags: radiation-wave4
- Phase: 3
- Setting: Advanced larynx cancer suitable for larynx preservation: concurrent cisplatin chemoradiation versus induction chemotherapy then radiotherapy versus radiotherapy alone
- Sponsor: Radiation Therapy Oncology Group
- Enrolled: 547
- Result: Larynx preservation at 2 years 88% (concurrent) vs 75% (induction) vs 70% (radiotherapy alone).
- Outcomes: Laryngectomy-free survival driver: larynx preservation at 2 years: Concurrent cisplatin chemoradiation 88% vs Induction chemotherapy then radiotherapy 75% vs Radiotherapy alone 70%

## Sources

- NEJM 2003: https://doi.org/10.1056/NEJMoa031317

## Connected records

- cancers: [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [Laryngeal and hypopharyngeal cancer](https://onco.cc/cancers/laryngeal-cancer/)
- technologies: [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [Radiosensitisers](https://onco.cc/technologies/radiosensitisers/)
- drugs: [Cisplatin](https://onco.cc/drugs/cisplatin/), [Fluorouracil (5-FU)](https://onco.cc/drugs/fluorouracil/)
- terms: [Chemoradiation (chemoradiotherapy, CRT)](https://onco.cc/terms/chemoradiation/)

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