title: Neo-adjuvant chemotherapy in advanced hypopharyngeal carcinoma.
abstract: OBJECTIVE
  The aim of this retrospective study was to find out the role of neo-adjuvant chemotherapy (NACT) in changing the management and outcome of advanced hypopharyngeal cancer patients.
  
  
  METHODS
  This is a retrospective analysis of 59 treatment naïve, advanced hypopharyngeal cancer patients presenting to our tertiary care center from April 2010 to October 2011. NACT was given as two (platinum with taxane) or three drug with (platinum, taxane with 5-flurouracil [5 FU]) as 3 weekly regimen with cisplatin and docetaxel as 75 mg/m 2 each, 5-FU as 1000 mg/m 2 . NACT was either given with the intent of achieving: (1) surgical resection (extensive soft tissue disease, oropharyngeal involvement, extensive disease with cartilage erosion) or (2) organ preservation (Bulky disease with inner cartilage erosion, exolaryngeal disease without cartilage erosion, large N3 nodes).
  
  
  RESULTS
  The mean age of this population was 55 years. Most (83%) of the patients had pyriform sinus (PFS) involvement. 69% patients had Stage IVa disease, 21% Stage IVb and 10% Stage III. The overall response rate was 66%, including 06% complete responses and 60% partial responses. Following NACT, resectability was achieved in 30% (10/33) and organ preservation protocol was planned after NACT in 73% (19/26) patients. The main toxicities were neutropenia (grade 3, 4, 04%; febrile neutropenia, 4%), mucositis 5%, diarrhea 5%. The median progression free survival was 20 months.
  
  
  CONCLUSIONS
  NACT can be useful in patients with oropharyngeal involvement to achieve surgical resection and larynx preservation in patients with bulky T3 disease.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: P
authors.initials: P
authors.lastname: Joshi
authors.forename: V
authors.initials: V
authors.lastname: Patil
authors.forename: A
authors.initials: A
authors.lastname: Joshi
authors.forename: V
authors.initials: V
authors.lastname: Norohna
authors.forename: P
authors.initials: P
authors.lastname: Chaturvedi
authors.forename: D
authors.initials: D
authors.lastname: Chaukar
authors.forename: P
authors.initials: P
authors.lastname: Pai
authors.forename: D
authors.initials: D
authors.lastname: Nair
authors.forename: S
authors.initials: S
authors.lastname: Juvekar
authors.forename: J P
authors.initials: JP
authors.lastname: Agarwal
authors.forename: A K
authors.initials: AK
authors.lastname: D'Cruz
authors.forename: K
authors.initials: K
authors.lastname: Prabhash
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001952:Bridged-Ring Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009503:Neutropenia / Q000209:etiology; D010984:Platinum / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; D000077143:Docetaxel; C080625:taxane; D010984:Platinum; D002945:Cisplatin; D005472:Fluorouracil