Advanced hypopharyngeal carcinoma treatment results according to treatment modalities.

ABSTRACT

BACKGROUND: The purpose of this retrospective study is to compare the treatment results of locally advanced hypopharyngeal carcinoma according to treatment modalities. METHODS: Seventy-three patients with locally advanced hypopharyngeal carcinoma treated at the Department of Therapeutic Radiology, Seoul National University Hospital, between August 1979 and July 1997 were retrospectively analyzed. Twenty-three patients were treated with radiotherapy (RT) alone, 18 patients were treated with surgery and postoperative RT, and 32 patients were treated with neoadjuvant chemotherapy (CTx) and RT. Median follow-up period was 28 months. RESULTS: The overall 5-year survival rates were 15.7% for the RT alone group, 46.8% for surgery and postoperative RT group, and 43.0% for neoadjuvant CTx and RT group. The 5-year disease-free survival rates were 13.9%, 47.4%, and 30.7%, respectively. Surgery and postoperative RT or neoadjuvant CTx and RT showed superiority over RT alone in terms of both overall survival and disease-free survival rates. No significant differences were found in overall and disease-free survival rates between the surgery and postoperative RT group and neoadjuvant CTx and RT group (p =.15, p =.13). In the neoadjuvant CTx and RT group, 12 patients (38%) retained their larynx more than 5 years. CONCLUSION: Neoadjuvant CTx and RT is an effective strategy to achieve organ preservation without compromising the survival of patients with locally advanced hypopharyngeal carcinoma.