[Concurrent chemoradiotherapy for advanced hypopharyngeal cancer].
BACKGROUND
Chemotherapy has been shown to be most effective when delivered concurrently with radiation for the patients with advanced stage tumors. We conducted a concurrent chemoradiation using systemic infusion of cisplatin (CDDP) and 5-fluorouracil (5-FU).


METHODS
Thirty-nine patients with advanced hypopharyngeal cancer received one or two cycles of intravenous administration of CDDP (80-100 mg/m2) followed by 120-hour continuous infusion of 5-FU (800-1000 mg/m2), and concomitant radiotherapy (200 cGy/day x 20-35 fractions) during the period from December, 1993 through December, 2001. Three of them were in stage III, 31 in stage IVA, and 5 in stage IVB. Until 1999 definitive surgery was planed in almost all the patients, however, primary tumors had pathologically disappeared in eleven out of the 20 (55%) of the surgical specimens. Based on the result, definitive surgery was reserved for residual or recurrent tumors afterwards.


RESULTS
The complete response (CR) rates according to the T factor were 100% (1/1) for T1, 86% (6/7) for T2, 67% (2/3) for T3, and 50% (14/28) for T4, respectively. Two cycles of chemotherapy yielded a significantly higher CR rate than that of one cycle (P = 0.0371). One patient died of aspiration pneumonia. The rate of grade 3-4 leukocytopenia was 38%. The projected 5-year disease specific and overall survival rates were 57 and 51%, respectively.


CONCLUSIONS
Concurrent chemoradiotherapy is promising as far as improving survival as well as organ preservation.
Endo
Sohei
S
Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo.
Suzuki
Shin
S
Tsuji
Kenzo
K
Nomura
Yasuyuki
Y
Noguchi
Yugo
Y
Kida
Akinori
A
Saito
Tsutomu
T
Tanaka
Yoshiaki
Y
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil