title: Concurrent chemoradiotherapy improves survival in patients with hypopharyngeal cancer.
abstract: OBJECTIVE
  To retrospectively review our institutional experience with hypopharyngeal carcinoma with respect to treatment modality.
  
  
  METHODS
  A total of 70 patients with hypopharyngeal cancer treated between 1999 and 2009 were analyzed for functional and survival outcomes. The treatments included surgery alone (n = 5), surgery followed by radiotherapy (RT) (n = 3), surgery followed by chemoradiotherapy (CRT) (n = 13), RT alone (n = 2), CRT alone (n = 22), induction chemotherapy followed by RT (n = 3), and induction chemotherapy followed by CRT (n = 22).
  
  
  RESULTS
  The median follow-up was 18 months. The median overall survival and disease-free survival for all patients was 28.3 and 17.6 months, respectively. The 1- and 2-year local control rate for all patients was 87.1% and 80%. CRT, given either as primary therapy or in the adjuvant setting, improved overall survival and disease-free survival compared with patients not receiving CRT. The median overall survival and disease-free survival for patients treated with CRT was 36.7 and 17.6 months vs. 14.0 and 8.0 months, respectively (p < .01). Of the patients initially treated with an organ-preserving approach, 4 (8.2%) required salvage laryngectomy for local recurrence or persistent disease; 8 (16.3%) and 12 (24.5%) patients were dependent on a percutaneous gastrostomy and tracheostomy tube, respectively. The 2-year laryngoesophageal dysfunction-free survival rate for patients treated with an organ-preserving approach was estimated at 31.7%.
  
  
  CONCLUSIONS
  Concurrent CRT improves survival in patients with hypopharyngeal cancer. CRT given with conventional radiation techniques yields poor functional outcomes, and future efforts should be directed at determining the feasibility of pharyngeal-sparing intensity-modulated radiotherapy in patients with hypopharyngeal tumors.
authors.affiliation: Department of Radiation Oncology, Wayne State University, Detroit, MI 48201, USA. ppaximad@med.wayne.edu
authors.forename: Peter
authors.initials: P
authors.lastname: Paximadis
authors.forename: George
authors.initials: G
authors.lastname: Yoo
authors.forename: Ho-Sheng
authors.initials: HS
authors.lastname: Lin
authors.forename: John
authors.initials: J
authors.lastname: Jacobs
authors.forename: Ammar
authors.initials: A
authors.lastname: Sukari
authors.forename: Greg
authors.initials: G
authors.lastname: Dyson
authors.forename: Michael
authors.initials: M
authors.lastname: Christensen
authors.forename: Harold
authors.initials: H
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D060828:Induction Chemotherapy / Q000379:methods*; D007830:Larynx; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome