Critères d'inclusion : - Squamous cell carcinoma of the larynx or hypopharynx, histologically proven, locally advanced:
-> T2 not accessible to a supra-cricoid partial laryngectomy or not,
-> T3 without massive infiltration by endolarynx transglottic injury,
-> N0 to N2c
-> No distant metastasis
-> No associated cancer or earlier
- Patients Previously Untreated
- Age> 18 years and <75 years
- PS 0 or 1 according to WHO
- Tumor volume assessable by RECIST.
- Absence of distant metastasis, confirmed by chest TDM, abdominal ultrasound (or TDM) in case of abnormal liver function and bone scan if local symptoms.
- Absence of any participation in a clinical trial within 30 days prior to inclusion.
- Absence of any concomitant cancer treatment.
- Absence of any chronic treatment ( ≥3 months) with a daily corticosteroid dose is ≥20 mg / day of methylprednisolone or equivalent.
- Hematological function: neutrophils ≥1.5 x 109 / L, platelets ≥100 x 109 / l, hemoglobin ≥10 g / dl (or 6.2 mmol / l).
- Hepatic function: normal total bilirubin; AST (SGOT) and ALT (SGPT) ≤ 2.5 x ULN (LNS) of each center; alkaline phosphatase ≤ 5 x LNS.
- Renal function: serum creatinine ≤ 120 mol / l (1.4 mg / dl); if creatinine > 120 mol / l, creatinine clearance should be ≥ 60 ml / min.
- calculated creatinine clearance (Crockcroft formula) or measured ≥ 60 ml / min
- Estimated life expectancy ≥ 3 months
- Weight loss less than 10% over the last 3 months
- VHI and DHI questionary
- Quality of Life Questionnaire QLQ-C30 and QLQ-H & N35
- Patient has given its written consent before any specific procedure of the Protocol.
- Women and men of childbearing age should have accepted a medically effective contraception during the treatment period and at least 6 months after discontinuation of study treatments (Docetaxel, 5-Fluorouracil and Cisplatin. If pregnancy is declared by a patient or partner of a patient, it must be followed to know the evolution of pregnancy.
- Dynamic Vidéoscopie of deglutition
Critères de non-inclusion : - transglottic T3 with massive infiltration of hemilarynx or T4 with massive cartilaginous tumor lysis or reverse cricoarythénoïdenne region or posterior hypopharyngeal wall
- tumor requiring the completion of an immediately tracheotomy.
- Tumour available immediately to partial surgery.
- tumor requiring circular hypopharyngectomie
- N3 nodal injury
- Vaccination against yellow fever recent or anticipated
- Deficit known dihydropyrimidine dehydrogenase (DPD)
- Other malignancies within 5 years prior to randomization, with the exception of adequately treated basal skin cancer and carcinoma in situ of the cervix.
- Patients with AST or ALT> 1.5xULN associated with alkaline phosphatase > 2.5x LNS will not be eligible for testing.
- symptomatic neuropathy grade ≥2 with NCI-CTC.
- Clinical alteration of hearing function.
- Other concomitant serious medical conditions (partial list):
-> Unstable cardiac disease despite treatment.
-> Myocardial infarction within 6 months prior to trial entry.
-> Neurological or psychiatric history such as dementia, seizures;
-> Severe uncontrolled infection.
-> Significant gastrointestinal abnormalities, including those that require parenteral nutrition, active peptic ulcer disease and a history of surgical procedures affecting absorption
-> Obstructive pulmonary disease requiring hospitalization in the year before inclusion.
-> Unstable diabetes or other cons-indications to corticosteroids.
-> Significant ophthalmologic abnormality.
-> Moderate or severe eczema.
- Allergy to iodine.
- Hypersensitivity to Docetaxel, Cisplatin or at one of their excipients.
- Concomitant use of phenytoin, carbamazepine, barbiturates and rifampicin.
- Presence, selection, psychological factors, family, social or geographical may alter patient compliance with the study protocol and follow-up, a criterion of non-inclusion. These factors should be discussed with the patient before inclusion in the trial.
- Pregnant or nursing women.
- Patient (male or female) of childbearing age not taking adequate contraceptive measures.