Induction Docetaxel/Cisplatin/5-fluorouracil (TPF) as Selector for Chemo Radiation Therapy (RT) Versus Partial Laryngectomy in Advanced Laryngeal Cancer

Inclusion Criteria:

* Patients must have pathologically confirmed previously untreated, resectable, squamous cell carcinoma of the larynx.
* Disease must be Stage III or IV.
* Tumor must be potentially surgically resectable and curable with conventional surgery and radiation therapy.
* Patients must undergo pre-treatment endoscopic tumor staging and CT scanning of chest and neck.(pet scan optional)
* Eastern Cooperative Oncology Group (ECOG) Performance status 0-2.
* Pre-treatment laboratory criteria:

  * WBC \> 3500/ul, granulocyte \> 1500/ul.
  * Platelet count \> 100,000/ul.
  * Calculated or measured creatinine clearance \> 60 cc/min.
  * AST and ALT \< 2.5 X ULN
* Patients must give documented informed consent to participate in this study.

Exclusion Criteria:

* Prior head and neck malignancy or active non-head and neck malignancy. Except for cured non-melanoma skin cancer,
* Prior head and neck radiation.
* Documented evidence of distant metastases.
* Active infection.
* Pregnancy or lactation. Patients must agree to use adequate contraception (hormonal or barrier method of birth control) prior to study entry, for the duration of study participation and for 3 months after discontinuing therapy.
* Any medical or psychiatric illness which in the opinion of the principal investigator would compromise the patient's ability to tolerate this treatment.
* Age \< 18 years.
* Patients with psychiatric/social situations that would limit compliance with study requirements are not eligible.
* Patients with Grade \> 2 peripheral neuropathy.
* Any history of severe hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80.

Criteria for supracricoid resection for chemo selection non responders

Inclusion Criteria :

* At least one functional arytenoids (physical and radiological examinations)
* Involvement of thyroid cartilage including extrathyroid cartilage extension.

Exclusion criteria:

* Subglottic extension anteriorly.
* Pre epiglottic extension.
* Subglottic extension laterally.
* Interarytenoid involvement.
* Two Arytenoids involved.

Criteria for supracricoid resection for Chemoradiation failure:

Inclusion Criteria:

* At least one functional arytenoid (physical and radiological examinations)
* Involvement of thyroid cartilage (with no radiological evidence for extra thyroid Extension).

Exclusion Criteria:

* Extrathyroid cartilage extension.
* Involvement preepiglottic space.
* Subglottic extension.
* Interarytenoid involvement.