ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Wednesday, July 3, 1996 TAG: 9607030038
SECTION: NATIONAL/INTERNATIONAL PAGE: A-5 EDITION: METRO
DATELINE: WASHINGTON
SOURCE: Associated Press
A STUDY FINDS that chemotherapy can save throat cancer patient's voice box.
Chemotherapy that preserves a patient's voice box and ability to speak is just as effective as surgery in treating some types of throat cancer, a study suggests.
Cancer experts say these and other recent findings give new choices in how to treat the disease.
A clinical trial involving about 200 patients with cancer of the throat showed that those who were treated with chemotherapy followed by radiation had at least an equal survival rate as patients treated first with a surgery that included removal of the voice box.
The study, conducted by the European Organization for Research and Treatment of Cancer, is being published today in the Journal of the National Cancer Institute.
Dr. Louis B. Harrison of Memorial Sloan-Kettering Cancer Center in New York and Dr. Arlene A. Forastiere of Johns Hopkins Oncology Center in Baltimore both said that the new study gives powerful new evidence that preserving the voice does not compromise the survival of some throat cancer patients.
``I think this is a very important finding because of the randomized nature of it,'' said Harrison, a throat cancer expert at Memorial Sloan-Kettering. ``Only in such a trial can you assure that you are not sacrificing the survival of the patient'' in order to preserve the voice box, or larynx.
``I don't think there is any question now that this approach [chemotherapy] can preserve the voice box without any decrease in survival rates. Now there is an alternative to having the surgery,'' Forastiere said. ``That's what this study provides.''
About 5 percent of all diagnosed U.S. cancers, some 9,000 cases, involve structures in the throat that could affect the voice or the ability to swallow.
The most common primary treatment has been to surgically remove the tumors, along with a margin of normal tissue. This meant that throat cancer patients often lost their voice box. The surgery can also affect breathing and swallowing.
In the European study, 194 patients with cancer of the pyriform sinus, a throat structure next to the larynx, were assigned to receive either immediate surgery or cancer drugs as initial therapy. The primary treatment for both groups would be followed with radiation therapy.
The surgery involved removal of the voice box, while chemotherapy offered the chance of preserving the voice.
Almost 86 percent of the patients receiving chemotherapy experienced a complete or partial response, although some developed cancer at distant sites. Thirty-four of the chemotherapy patients later required surgery.
After three years, 57 percent of the patients who started therapy with drugs were still alive, while only 42 percent of the patients in the surgical arm of the study were living. After five years, the survival rates were essentially the same: 25 percent for the chemotherapy patients, and 27 percent for the patients who started treatment with surgery.
``This study is extremely well done,'' Forastiere said. ``There is no question about the results.''
She said that a study conducted by Department of Veterans Affairs researchers three years ago found similar results among patients with cancer of the larynx.
Both Johns Hopkins and Memorial Sloan-Kettering have conducted smaller studies comparing the two types of therapy. Harrison and Forastiere said their findings were similar to those of the larger studies.
LENGTH: Medium: 71 linesby CNB