Induction chemotherapy consisting of high dose cisplatin and infusional 5-FU (PF) followed by definitive radiation therapy for the past decade has been the organ-sparing alternative to surgery for patients with laryngeal and hypopharyngeal squamous cell carcinomas. Recent preliminary data from a large randomized trial, RTOG91-11, comparing this approach with concurrent cisplatin and radiation and radiation alone suggest that induction therapy achieves parity with concurrent therapy with respect to survival, but concurrent therapy seems to offer the possibility of greater rates of larynx preservation. If final results of RTOG 91-11 confirm the preliminary evaluation, it is probable that induction therapy will be displaced by concurrent platinum-based therapy as the standard of care.