Organ preservation with radiotherapy for T1‐T2 carcinoma of the pyriform sinus

Abstract

RT alone or combined with a planned neck dissection resulted in local control with larynx preservation in a high proportion of patients. The chance of cure is comparable to that observed after conservation surgery, and the risk of major complications is lower. The addition of adjuvant chemotherapy is unlikely to improve the probability of organ preservation, but might improve locoregional control for patients with advanced nodal disease.

Resection of selected invasive squamous cell carcinoma of the pyriform sinus by means of the lateral pharyngotomy approach: The partial lateral pharyngectomy

“…Amdur et al 22,25 reported on 101 patients with T1/2 pyriform sinus carcinoma treated with radiotherapy to the primary and post-radiotherapy neck dissection. Actuarial local control was 90% for T1 and 80% for T2 lesions, respectively.…”

“…We believe that to achieve such results, surgical technique must be precise to guarantee preservation of the superior laryngeal nerve in this open-field surgical approach. Such functional outcomes should be compared with much higher rates of permanent tracheotomy and gastrostomy when using, on the one hand, hyperfractionated radiotherapy 22,25 or, on the other hand, supraglottic 16 or supracricoid hemilaryngopharyngectomy. 17,18 Because the incidence of pyriform sinus carcinoma is rare, large adequately powered studies to compare treatment regimens have not been performed.…”

“…These include the partial laryngopharyngectomy, 4,6 the extended supraglottic laryngectomy, 16 the supracricoid hemilaryngopharyngectomy, 17,18 and the transoral endoscopic CO 2 laser resection. 19,20 In addition, innovative radiation therapy protocols, including twice-daily hyperfractionation 21,22 and chemoradiation, 23,24 have been proposed. We present here a longitudinal report documenting the results of the lateral pharyngectomy.…”

Posterior pharyngeal wall carcinoma presenting as sudden onset bilateral upper limb radiculopathy

“…Overall, local control rates with RT for PPW carcinomas are reported to be 36% at 5 years 7. However, the 5-year overall survival for stage IV-B disease is just 5% after RT alone 8.…”

Funktionserhaltende Therapie des Kehlkopf- und des Hypopharynxkarzinoms

“…In einer nachfolgenden Publikation aus derselben Institution wurde die 5-Jahresrate f ü r die lokale Tumorkontrolle mit 90 % f ü r T1-und 80 % f ü r T2-Karzinome angegeben. Die lokale Kontrolle mit Organerhalt betrug f ü r Patienten mit T1-Karzinomen 86 % und f ü r Patienten mit T2-Karzinomen 82 %[256] . Garden et al[222] konnten bei 57 T1-und T2-Karzinomen in 75,5 % der F ä lle den Tumor lokal beherrschen.…”