RTOG 91-11
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.
Overview
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.
- 88 vs 75 out of 100 reached this endpoint at 2 years with Concurrent cisplatin chemoradiation compared with Induction chemotherapy then radiotherapy; 13 more per 100.
- Roughly one extra person helped for every 8 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Other groups: Radiotherapy alone 70 of 100.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Advanced larynx cancer suitable for larynx preservation: concurrent cisplatin chemoradiation versus induction chemotherapy then radiotherapy versus radiotherapy alone. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
547 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Laryngectomy-free survival driver: larynx preservation at 2 yearsprimary | Concurrent cisplatin chemoradiation | 172 | 88% | - | - | - |
| Induction chemotherapy then radiotherapy | 173 | 75% | ||||
| Radiotherapy alone | 173 | 70% |
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