Background. The standard initial management of patients with locally advanced pharyngolaryngeal presenting with
stridor is
tracheostomy.
Tracheostomy has been shown to negatively impact
cancer-related outcomes. Methods. Retrospective analysis of prospectively collected data of 9 patients, who underwent
induction chemotherapy with the aim of prevention of
tracheostomy. Presenting features, time to resolution of
stridor, and further management are reported. Results. Eight out of 9 patient received
chemotherapy within 12 hours of presentation with
stridor. There were 4 patients each with primary hypopharynx and larynx. The stage was IVA in 6 patients and IVB in 2 patients. In all patients receiving immediate
chemotherapy, clinical
stridor resolved within 48 hours. The radiological response rate was 62.5%. The median reduction in size of
tumor was 37%. Conclusion. Immediate
neoadjuvant chemotherapy is a feasible and safe option for patients presenting with early
stridor and helps in resolution of
stridor and avoiding
tracheostomy.