title: Laryngeal preservation in advanced piriform sinus squamous cell carcinomas using superselective intra-arterial chemoradiation therapy with three agents.
abstract: CONCLUSIONS
  Superselective intra-arterial chemotherapy, which enables local control and laryngeal preservation, is a safe and useful therapy for preservation of nutrition, speech, and swallowing functions.
  
  
  OBJECTIVE
  To improve the laryngeal preservation rate in patients with hypopharyngeal piriform sinus squamous cell carcinoma by superselective intra-arterial chemotherapy.
  
  
  METHODS
  Fifty-seven patients received anterograde intra-arterial administration of docetaxel and cisplatin, and two courses of intravenous continuous infusion of 5-fluorouracil as a neoadjuvant chemotherapy over 120 h starting on day 2. Concurrent chemoradiotherapy was administered from the third course to control the primary cancer. Remaining neck lymph node metastases were treated in principle by neck dissection.
  
  
  RESULTS
  The 5- and 10-year survival rates were 68.5% and 58.9%, respectively. The 5-year rates by the T classification were 96.0% (10-year rate, 88.6%) in T3, 48.1% in T4a, and 16.7% in T4b. The 5- and 10-year laryngeal preservation rates were 65.2% and 62.4%, respectively. The 5-year rates by the T classification were 92.4% (10-year rate, 87.6%) in T3, 36.2% in T4a, and 16.7% in T4b. No irreversible side effects, complications, or sequelae were reported. Superselective intra-arterial chemotherapy showed superior laryngeal preservation as well as high survival rates, particularly in T3, and was considered a useful therapy.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan. furusaka.tohru@nihon-u.ac.jp
authors.forename: Tohru
authors.initials: T
authors.lastname: Furusaka
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuda
authors.forename: Akane
authors.initials: A
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuda
authors.forename: Minoru
authors.initials: M
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007261:Infusions, Intra-Arterial; D007830:Larynx; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D056144:Pyriform Sinus / Q000473:pathology; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil