Treatment results and prognostic factors in locally advanced hypopharyngeal cancer.
CONCLUSIONS
We suggest that concurrent chemoradiation (CCRT) is an effective definitive treatment for patients with advanced hypopharyngeal carcinoma who are unfit for or refuse surgery. A high dose of radiation (> 70 Gy) should be given to achieve acceptable local control rates and survival.


OBJECTIVE
The purpose of this retrospective study was to compare the treatment results of locally advanced hypopharyngeal carcinoma with two different protocols.


METHODS
From December 1995 to December 2004, 74 patients with locally advanced hypopharyngeal cancer were treated with CCRT or surgery plus postoperative radiotherapy (SRT). Their treatment results were reviewed by retrospective analysis. The study points included outcome, toxicity, and prognostic factors.


RESULTS
There was no significant difference in T and N status between the two treatment groups, nor were there significant differences in overall or disease-free survival or the incidence of distant metastasis (p >0.05). In the CCRT group and SRT group, the estimated 3-year overall survival was 39% and 44%, respectively. The SRT group had better local control than the CCRT group (p <0.05). Relatively, 27% patients retained their larynx function for more than 2 years in the CCRT group. Radiation doses >70 Gy yielded significantly better survival and local control than doses <70 Gy (p <0.05).
Lee
Moon-Sing
MS
Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Dalin, Chiayi, Taiwan.
Ho
Hsu-Chueh
HC
Hsiao
Shih-Hsuan
SH
Hwang
Juen-Haur
JH
Lee
Ching-Chih
CC
Hung
Shih-Kai
SK
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D016629:Esophagectomy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D007013:Hypopharynx / Q000473:pathology / Q000601:surgery; D053208:Kaplan-Meier Estimate; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010611:Pharyngectomy; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies
D002945:Cisplatin; D005472:Fluorouracil