title: Clinical outcomes of weekly cisplatin chemoradiotherapy for patients with pyriform sinus cancer.
abstract: BACKGROUND
  Pyriform sinus squamous cell carcinoma (SCC) has one of the worst prognoses of all upper aerodigestive tract cancers. Improving clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists.
  
  
  METHODS
  We investigated 30 patients with pyriform sinus SCC to verify the effectiveness of weekly cisplatin chemotherapy with concurrent radiotherapy. Cisplatin was administered at a dose of 40 mg/m(2) on weeks 1, 2, 3, 5, 6, and 7 during definitive radiotherapy with the aim of preserving the larynx.
  
  
  RESULTS
  All 30 patients achieved definitive radiotherapy at a median dose of 70 Gy (range 64-70 Gy). Cisplatin was administrated concomitantly a median of five times (range 2-6 times). Persistent or recurrent primary disease was observed in four patients (13 %). Persistent or recurrent nodal metastasis was observed in five patients (17 %). Nine salvage surgeries were performed for eight patients, of whom seven survived without any evidence of disease. Post-operative complications were observed in two patients (22 %). The 5-year overall survival and locoregional control rates were 87 and 96 %, respectively. The 5-year laryngeal preservation rate was 74 %.
  
  
  CONCLUSIONS
  The regimen of weekly cisplatin CRT may be effective for pyriform sinus SCC; however, there were problems with strong selection bias in the current study due to the large number of T2 patients. Salvage surgery was safe and was able to improve the survival rate. This chemoradiation regimen was considered successful in preserving laryngeal function.
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors: Tomohiro
authors: T
authors: Sakashita
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan. ak-homma@med.hokudai.ac.jp.
authors: Akihiro
authors: A
authors: Homma
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors: Hiromitsu
authors: H
authors: Hatakeyama
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors: Jun
authors: J
authors: Furusawa
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors: Satoshi
authors: S
authors: Kano
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors: Takatsugu
authors: T
authors: Mizumachi
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors: Satoshi
authors: S
authors: Iizuka
authors: Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Rikiya
authors: R
authors: Onimaru
authors: Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Kazuhiko
authors: K
authors: Tsuchiya
authors: Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Koichi
authors: K
authors: Yasuda
authors: Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Hiroki
authors: H
authors: Shirato
authors: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors: Satoshi
authors: S
authors: Fukuda
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D059351:Organ Sparing Treatments; D056144:Pyriform Sinus; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Chemoradiation; Hypopharyngeal cancer; Laryngeal preservation