title: Prognostic factors in patients with advanced hypopharyngeal squamous cell carcinoma treated with concurrent chemoradiotherapy.
abstract: OBJECTIVE
  The aim of this study was to evaluate different prognostic factors affecting response to treatment, locoregional control (LRC) and survival in patients with advanced hypopharyngeal squamous cell carcinoma (HPSCC).
  
  
  METHODS
  A retrospective analysis of 41 patients with advanced HPSCC who had undergone definitive concurrent chemoradiation treatment between January 2006 and October 2009 was performed.
  
  
  RESULTS
  Complete composite response (CCR) was achieved in 27 patients (65.9)). Significant prognostic factors for CCR were T stage, technique of radiation, and gross tumor volume (GTV). Unfavorable prognostic factors for CCR in multivariate analysis were higher T stage and radiation technique with electron-photon fields. The 2-year LRC rate was 51.3%. The 2-year disease-free survival (DFS) and overall survival (OS) rates were 29.3% and 32.8%, respectively. Significant prognostic factors for LRC, DFS, and OS in univariate analysis were T stage, overall stage, and GTV. OS was also significantly influenced by N stage. In multivariate analysis T stage was found to be the only significant independent prognostic factor for LRC (p=0.003), DFS (p=0.01), and OS (p=0.005).
  
  
  CONCLUSIONS
  Revealing the significant prognostic value of T stage for CCR, LRC, DFS, and OS in the multivariate analysis, we consider that the implementation of intensity modulated radiotherapy (IMRT) and the adoption of intensified concurrent chemoradiotherapy (CCRT), sequential therapy, and targeted therapy should be strongly advocated in order to improve outcome in patients with locally advanced HPSCC.
authors: Department of Head and Neck Cancer, University Clinic of Radiotherapy and Oncology, Skopje, FYROMakedonia. krstevskav@gmail.com
authors: V
authors: V
authors: Krstevska
authors: I
authors: I
authors: Stojkovski
authors: B
authors: B
authors: Zafirova-Ivanovska
authors: S
authors: S
authors: Crvenkova
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents