Clinical impact of using chemoradiotherapy as a primary treatment for hypopharyngeal cancer.
Eighty-eight patients with hypopharyngeal cancer who received chemoradiotherapy as the primary treatment between 1979 and 1997 were investigated. Forty-six patients who received surgery as the primary treatment were analyzed as a control group. There were no statistically significant differences regarding TN classification, tumor stage, tumor site, age or sex between the radiation and surgery groups. The 5-year cumulative survival rate of primary chemoradiotherapy was 47% and this did not differ significantly from that for the primary surgery group. The larynx was preserved in 74% of cases in the primary chemoradiotherapy group, a far better preservation rate than that in the surgery group. After primary chemoradiotherapy, complete remission (CR) was observed in 59% of cases and the average period of CR was 38 months. Among patients with residual tumor, a salvage operation was employed in 31 cases, 13 patients refused to receive surgery and 8 were inoperable. A salvage operation was performed in 35% of all cases and the 5-year cumulative survival rate was 50%. Based on the 5-year survival, primary CR, salvage and laryngeal preservation rates, we conclude that chemoradiotherapy is a good primary treatment for hypopharyngeal cancer.
Okamoto
Makito
M
Department of Otorhinolaryngology, School of Medicine, Kitasato University, Kanagawa, Japan. okamotom@med.kitasato-u.ac.jp
Takahashi
Hiroomi
H
Yao
Kazuo
K
Inagi
Katsuhide
K
Nakayama
Meijin
M
Nagai
Hiromi
H
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D010614:Pharynx / Q000187:drug effects / Q000528:radiation effects; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D014498:Uracil / Q000008:administration & dosage / Q000627:therapeutic use*
D000964:Antimetabolites, Antineoplastic; D011838:Radiation-Sensitizing Agents; D005641:Tegafur; D014498:Uracil; D002945:Cisplatin