title: Hypopharyngeal squamous cell carcinoma: Three-dimensional or Intensity-modulated radiotherapy? A single institution's experience.
abstract: OBJECTIVE
  Compare outcomes of hypopharyngeal carcinoma that received conventional radiotherapy versus intensity-modulated radiotherapy (IMRT).
  
  
  METHODS
  Retrospective single-institution trial.
  
  
  METHODS
  Between April 1990 and May 2011, 100 patients with hypopharyngeal cancer underwent curative radiotherapy (RT) at our institution: 50 with IMRT and 50 with conventional RT. The median age was 63 years. There were 12 T1, 22 T2, 37 T3, and 28 T4 patients. The majority of patients (82%) had nodal disease: 54% N2 and 8% N3. The majority of patients (83%) received chemotherapy. Of the patients who received chemotherapy, 84% received a platinum-based regimen. The median RT dose was 7,000 cGy. The majority of patients (62%) had prophylactic percutaneous endoscopic gastrostomy tube placement. Toxicities were reviewed. Local control (LC), locoregional control (LRC), freedom from distant metastasis (FFM) rates, functional larynx preservation (LP), laryngectomy-free survival (LFS), and overall-survival (OS) curves were generated using the Kaplan-Meier method. The log-rank test was used to test prognostic variables.
  
  
  RESULTS
  With a median follow up of 48.4 months, the 3/5-year LC, LRC, FFM, LP, LFS and OS rates were 74%/69%, 77%/74%, 70%/66%, 51%/29%, 49.6%/31.8%, and 49%/34%, respectively. The median OS was 2.9 years. The 3-year LC rate for IMRT was 77% versus 81% for conventional RT (P = .91); 3-year LRC for IMRT was 85% versus 76% for conventional RT (P = .32). There was no increased local failure with IMRT. There was no difference in the rate of stricture with IMRT (32%) versus conventional RT (25.3%) (P = .86).
  
  
  CONCLUSIONS
  IMRT achieved comparable LC and LRC rates to conventional RT.
  
  
  METHODS
  4 Laryngoscope, 126:620-626, 2016.
authors.affiliation: Department of Radiation Oncology.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Katsoulakis
authors.affiliation: Department of Radiation Oncology.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Riaz
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital, Shandong, China.
authors.forename: Man
authors.initials: M
authors.lastname: Hu
authors.affiliation: Department of Surgical Oncology ENT.
authors.forename: Luc
authors.initials: L
authors.lastname: Morris
authors.affiliation: Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York, U.S.A.
authors.forename: Eric
authors.initials: E
authors.lastname: Sherman
authors.affiliation: Department of Radiation Oncology.
authors.forename: Sean
authors.initials: S
authors.lastname: McBride
authors.affiliation: Department of Radiation Oncology.
authors.forename: Nancy
authors.initials: N
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D021621:Imaging, Three-Dimensional; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D011859:Radiography; D020266:Radiotherapy, Conformal / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Intensity-modulated radiotherapy; hypopharyngeal carcinoma; organ preservation