Preoperative concurrent chemoradiotherapy versus pre- and postoperative radiotherapy for advanced hypopharyngeal carcinoma: a single-center study.
OBJECTIVE
The purpose of this study was to improve the survival and phonatory rates in patients with advanced hypopharyngeal carcinoma.


METHODS
Seventy-two consecutive patients with advanced hypopharyngeal carcinoma were treated with pre- and postoperative radiotherapy (RTS), or preoperative concomitant chemoradiotherapy (CCRTS). Surgical procedures, including total laryngectomy plus partial pharyngectomy (TLPP) to preserve the posterior pharyngeal wall offering a functional neoglottis for esophageal or tracheoesophageal shunt phonation postoperatively, were conducted for patients who did not achieve CR.


RESULTS
A significantly higher survival rate at 5 years (93.3%) was observed for N0-2b stage patients in the CCRTS group (n=16) than the RTS group (n=34; 41.5%) (p<.005). The distant metastasis-free rate was 92.9% (CCRTS group) versus 55.4% (RTS group) (p<.05) in these patients. In the CCRTS group, the 5-year survival rate with laryngeal or esophageal and/or tracheoesophageal shunt phonation was 22.2%.


CONCLUSIONS
It is suggested that the CCRTS protocol and TLPP procedure may improve the survival rates without deterioration of phonatory rates in patients with N0-2b advanced hypopharyngeal carcinoma.
Iwai
Hiroshi
H
Department of Otolaryngology, Kansai Medical University, Osaka 570-8507, Japan. iwai@takii.kmu.ac.jp
Yukawa
Hisaya
H
Nagata
Motoki
M
Inoue
Toshiya
T
Omae
Mariko
M
Yamashita
Toshio
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D010699:Phonation; D011182:Postoperative Care; D011300:Preoperative Care; D016896:Treatment Outcome