Prognostic factor of severe complications in patients with hypopharyngeal cancer with primary concurrent chemoradiotherapy.
OBJECTIVE
Organ-preservation treatment for hypopharyngeal cancer has recently become a popular treatment option. However, the severe complications and poor quality of life after non-surgical treatment should be avoided. We accessed the laryngeal or pharyngeal dysfunction-related complications after concurrent chemoradiotherapy (CCRT) as the primary treatment for hypopharyngeal cancer.


METHODS
Data concerning all patients treated for hypopharyngeal cancer with primary non-surgical treatment at the China Medical University Hospital from 2002 to 2012 were retrospectively reviewed.


RESULTS
A total of 161 patients were included with a median age of 56.6 years. The disease control rates (disease-free >12 months) and severe complication rates were correlated to the tumor (T) stage and nodal (N) stage. In the successful treatment group, the complication rate was related to the N stage. The overall pharyngeal dysfunction, laryngeal dysfunction and aspiration rates were 36%, 27% and 25%, respectively. For patients with T4a disease, hyoid bone invasion significantly increased the severe complication rate (p=0.0212).


CONCLUSIONS
The treatment outcome was correlated to the T and N stage. A higher rate of laryngopharyngeal dysfunction occurred when treating hyoid bone invasion in T4a patients with primary non-surgical treatment. In advanced stage, but still resectable hypopharyngeal tumors, the poorer quality of life due to non-function larynx was noted after treating with CCRT.
Department of Otorhinolaryngology-Head and Neck Surgery China Medical University Hospital, Taichung, Taiwan, R.O.C.
Liang-Yu
LY
Chen
Department of Otorhinolaryngology-Head and Neck Surgery China Medical University Hospital, Taichung, Taiwan, R.O.C.
Chia-Chang
CC
Huang
Department of Otorhinolaryngology-Head and Neck Surgery China Medical University Hospital, Taichung, Taiwan, R.O.C. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.
Yung-An
YA
Tsou
Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C. Terry Fox Cancer Research Lab, China Medical University Hospital, Taichung, Taiwan, R.O.C. datian@mail.cmuh.org.tw artbau2@gmail.com.
Da-Tian
DT
Bau
Department of Otorhinolaryngology-Head and Neck Surgery China Medical University Hospital, Taichung, Taiwan, R.O.C. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.
Ming-Hsui
MH
Tsai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life; D016896:Treatment Outcome
Hypopharyngeal cancer; chemoradiotherapy; complication; hyoid bone; larynx preservation