Chemotherapy for Laryngeal and Hypopharyngeal Cancers

Chemotherapy drugs are used to kill cancer cells. These drugs can be given in pill or liquid form and taken by mouth. They can also be injected into a vein or muscle, under the skin, or into the tumor.

Many doctors now recommend a combination of chemotherapy and radiation therapy (chemoradiation) as the main treatment for cancers of the larynx to avoid surgically removing the larynx (laryngectomy).

Chemotherapy drugs are sometimes given before surgery for laryngeal and hypopharyngeal cancers to shrink the tumor (neoadjuvant therapy). This can allow the surgeon to use less radical techniques and remove less tissue. Chemotherapy is also used, often in combination with radiation therapy, after surgery (adjuvant therapy) to reduce the chance that the cancer will come back (recur) or to treat the symptoms of laryngeal and hypopharyngeal cancers that are too large to remove completely by surgery.

The drugs that seem to be most effective for laryngeal and hypopharyngeal cancers are:

• Adrucil^® or Efudex^® (5-fluorouracil or 5-FU) - 5-FU is an antimetabolite drug. 5-FU prevents cells from making DNA and RNA, which stops cells from growing. 5-FU is given as a shot in the vein. The treatment can be repeated every week, every other week, or every 3 weeks. The dose depends on your size.
• Blenoxane^® (bleomycin) - Bleomycin is an antibiotic. Bleomycin interferes with cell division, which destroys the cells. Bleomycin is given by a shot into a vein or as a shot into the muscle or under the skin. The dose is based on your size.
• Hydrea^® or Droxia^® (hydroxyurea) - Hydroxyurea is an antimetabolite drug. It prevents cancer cells from making DNA and RNA, which stops the cells from growing. The drug is given in capsule or pill form. The dose depends on how well your kidneys work and your blood counts.
• Paraplatin^® (carboplatin) - Carboplatin is a platinum chemotherapy drug that belongs to a group of drugs known as alkylating agents. It stops cancer cells from growing, which kills them. Carboplatin is given as an injection in the vein. The dose depends upon your size but may be lowered or not given if your blood counts are low.
• Platinol^® (cisplatin) - Cisplatin is a platinum compound chemotherapy drug that acts like an alkylating agent. It stops cancer cells from growing, which kills them. Cisplatin is given by an injection into the vein. Your dose depends on the type of cancer you have and your size.
• Rheumatrex^® or Trexall™ (methotrexate) - Methotrexate is an antimetabolite drug. It prevents cells from making DNA and RNA, which stops the growth of cancer cells. Methotrexate is given as a pill by mouth, an injection in a vein, or an injection into a muscle. The dose depends on your size and the type of cancer you have.
• Taxol^® or Onxol^® (paclitaxel) - Paclitaxel belongs to a class of chemotherapy drugs called taxanes. It is also called a mitotic inhibitor because it affects cells during mitosis (cell division). It stops cells from dividing, which kills them. Paclitaxel is given by an injection into a vein. The dose depends on your weight, the side effects you have, and how often the medicine is given.
• Taxotere^® (docetaxel) - Docetaxel belongs to a class of chemotherapy drugs called taxanes. It is also called a mitotic inhibitor because of its effect on the cell during mitosis (cell division). Docetaxel stops cancer cells from growing, which kills them. Docetaxel is given by a shot in a vein. The dose depends on your size, how well your liver is working, and how often the medicine is given.

A combination of cisplatin and 5-FU is often used to treat cancers of the larynx and hypopharynx.

This content has been reviewed and approved by Myo Thant, MD.