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J Korean Soc Ther Radiol Oncol > Volume 25(3); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(3): 151-159.
Treatments Results and Prognostic Factors in Locally Advanced Hypopharyngeal Cancer
Mee Sun Yoon, Woong Ki Chung, Sung Ja Ahn, Taek Keun Nam, Ju Young Song, Byung Sik Nah, Sang Cheol Lim, Joon Kyoo Lee
1Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea. wkchung@chonnam.ac.kr
2Department of Otolaryngology and Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea.
The purpose of this study is to present the treatment results and to identify possible prognostic indicators in patients with locally advanced hypopharyngeal carcinoma.
Between October 1985 to December 2000, 90 patients who had locally advanced stage IV hypopharyngeal carcinoma were studied retrospectively. Twelve patients were treated with radiotherapy alone, 65 patients were treated with a combination of chemotherapy and radiotherapy, and 13 patients were treated with surgery and postoperative radiotherapy with or without neoadjuvant chemotherapy. Total radiation dose ranged from 59.0 to 88.2 Gy (median 70 Gy) for radiotherpay alone. Most patients had ciplatin and 5-fluorouracil, and others had cisplatin and pepleomycin or vincristin. Median follow-up period was 15 months. Kaplan-Meier method was used for survival rate and Cox proportional hazard model for multivariate analysis of prognostic factors.
Overall 3- and 5-year survival rates were 27% and 17%, respectively. The 2-year locoregional control rates were 33% for radiotherapy alone, 32% for combined chemotherapy and radiotherapy, and 81% for combined surgery and radiotherapy (p=0.006). The prognostic factors affecting overall survival were T stage, concurrent chemoradiation and treatment response. Overall 3- and 5-year laryngeal preservation rates in combined chemotherapy and radiotherapy were 26% and 22%, respectively. Of these, the 5-year laryngeal preservation rates were 52% for concurrent chemoradiation group (n=11), and 16% for neoadjuvant chemotherapy and radiotherapy (n=54, p=0.012).
Surgery and postoperative radiotherapy showed better results than radiotherapy alone or with chemotherapy. Radiotherapy combined with concurrent chemotherapy is an effective modality to achieve organ preservation in locally advanced hypopharyngeal cancer. Further prospective randomized studies will be required.
Key Words: Hypopharyngeal carcinoma, Radiotherapy, Chemoradiation, Concurrent chemoradiation
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