Skip to main content

REVIEW article

Front. Oncol.
Sec. Head and Neck Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1494854
This article is part of the Research Topic 150 Years of Laryngectomy: Reviews on the State of the Art and Future Perspectives View all articles

Non-surgical organ preservation and new technologies laryngeal radiation

Provisionally accepted
Andreas Dietz Andreas Dietz 1*Eckel Hans Eckel Hans 2Alexander De Vries Alexander De Vries 3Markus Brunner Markus Brunner 4
  • 1 Leipzig University, Leipzig, Germany
  • 2 Hals-Nasen-Ohrenklinik, KABEK Klinikum Klagenfurt, Austria, Klagenfurt, Australia
  • 3 Klinik für Radioonkologie und Strahlentherapie, Vorarlberger Landeskrankenhäuser Feldkirch, Austria, Feldkirch, Austria
  • 4 Klinische Abteilung für Hals-, Nasen-, Ohrenkrankheiten, Universitätsklinikum Krems, Austria, Krems, Australia

The final, formatted version of the article will be published soon.

    The term "larynx organ preservation" (LOP) has become a synonym for nonsurgical laryngeal cancer treatment based on chemo-and radiation multimodality therapy (simultaneous chemoradiation, CRT or neoadjuvant chemotherapy followed by radiotherapy NCT+RT). Currently, the distinction between good and bad candidates of LOP is not clear, and the decision for surgical or non-surgical treatment depends on the patient´s needs and desires, the experience and recommendation of the surgeon, the philosophy of the institution and others. Nevertheless, the major disadvantage of LOP by CRT and NCT+RT is the potential need for salvage surgery due to tumor persistence after application of full per-protocol treatment. Head and neck surgeons worldwide complain that in principle salvage surgery is frequently possible after CRT but causes major complications and is not feasible in a relevant number of patients. While NCT+RT is globally used to select responders for LOP, NCT alone has not been shown to improve overall survival. Therefore, the worldwide use of NCT+RT for better selection of responders for LOP has been established; however, NCT as part of a multimodal concept could not improve overall survival. Therefore, this procedure has lost its influence in standard head and neck cancer treatment beyond LOP. Recently, NCT as part of perioperative transoral surgical treatment concept in Head Neck Cancer is gaining interest again. In addition to conventional chemotherapy, the combination with immuno checkpoint-inhibitors as neoadjuvant concept showed to be effective in non-controlled trials by opening a new door of encouraging treatment options for LOP.

    Keywords: larynx organ preservation, induction chemo therapy, Laryngectomy, head and neck cancer, Non surgical treatment

    Received: 11 Sep 2024; Accepted: 21 Oct 2024.

    Copyright: © 2024 Dietz, Hans, De Vries and Brunner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Andreas Dietz, Leipzig University, Leipzig, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.