Retrospective analysis of the clinical efficacy of definitive chemoradiotherapy for patients with hypopharyngeal cancer

Abstract

The efficacy and safety of definitive chemoradiotherapy are considered feasible with sufficient laryngeal preservation.

Surgery is not the only determinant of an outcome in patients with hypopharyngeal carcinoma

“…Bozec recorded a similar circumstance of better larynx preservation with induction chemotherapy of docetaxel, cisplatin, and 5‐fluorouracil . However, a concern is raised whether this approach leaves the patient with a functioning larynx . Bozec noted that those patients who responded to induction chemotherapy were more likely to require permanent enteral nutrition .…”

“…Edson, in a series of 98 patients, noted a functional laryngeal preservation rate of 76% at 2 years, with an advantage to concurrent CRT, however, for a grade 3 toxicity rate of 21% at 5 years . Sharma reported better outcomes in patients treated with concurrent CRT as did Takehana . Bonner retrospectively evaluated the definitive cetuximab/RT trial and noted 86% laryngeal preservation rate for those patients treated by RT, with comparable outcomes for those treated by cetuximab/RT, for a subset of patients with a hypopharyngeal primary.…”

“…26 Sharma 27 reported better outcomes in patients treated with concurrent CRT as did Takehana. 28 Bonner retrospectively evaluated the definitive cetuximab/ RT trial 29 and noted 86% laryngeal preservation rate for those patients treated by RT, with comparable outcomes for those treated by cetuximab/RT, for a subset of patients with a hypopharyngeal primary. Induction chemotherapy to RT has been used as a larynx preserving approach in hypopharyngeal carcinoma, 30 with Yanagi reporting on 43 patients with a 3-year local control rate of 81% in responders, compared to 40% in nonresponders.…”

“…32 However, a concern is raised whether this approach leaves the patient with a functioning larynx. 28 Bozec noted that those patients who responded to induction chemotherapy were more likely to require permanent enteral nutrition. 32 Lim recorded a 3-year progression-free survival of 42% with concurrent CRT, worse than, with comparable treatment, at other head and neck sites.…”

Treatment package time predicts cancer‑specific survival and distant metastasis in laryngeal cancer

“…We recommended postoperative RT with or without chemotherapy to patients with multiple lymph node metastasis, extranodal extension, and positive resection margin. Salvage surgery was performed for residual tumor found on pathological and imaging examination at 1-2 months after the completion of RT with or without chemotherapy, as described previously (11). After completion of the initial treatments, including salvage surgery for residual tumor, we made an effort to perform salvage surgery based on the presence of tumor recurrence.…”