238 patients with squamous cell carcinoma of the upper aerodigestive tract were given 3 cycles of chemotherapy [cisplatinurn (cis-DDP), 100 rngl m2 on day 1 ; 5-fluorouracil (5-FU), 1,000 mg/m2 on days 2-61 before any local treatment. Eighty-one of these patients had pharyngolaryngeal cancer. O f the 45 of 50 laryngeal cancers and 26 of 31 hypopharyngeal cancers suitable for evaluation, complete responses (CR) were obtained in 51.1% and 53.8%, respectively. These response rates led to changes in the postchemotherapy protocols. For CRs, mutilating surgical protocols were replaced by definitive radiotherapy: one local recurrence has been observed among the 9 laryngeal cancers, and 3 of 10 hypopharyngeal cancer patients, who had an initial indication of total laryngectomy or total pharyngolaryngectorny replaced by radiotherapy. In the group of CR, survival rates at 2 years were 93% and 69%, respectively, for the larynx and hypopharynx vs 65.6% and 40% for non-CR patients. The possibility of conservative treatment sparing vocal function with a high degree of reliability would in itself appear to be justification for induction chemotherapy in pharyngolaryngeal cancers, even though its long-term effects remain controversial. HEAD & NECK 12:225-231,1990 From the Departments of Otorhinolaryngology (Drs. Demard, Santini, and Vallicioni), Radiotherapy (Dr. Chauvel). and Medical Oncology (Drs. Thyss and Schneider). Centre Antoine-Lacassagne,