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• W2554639052 abstract "Prognosis of T3/T4 hypopharyngeal cancer (HPC) are unfavorable despite the multidisciplinary treatment approach, such as combined definitive radiation therapy (DRT) with concurrent chemotherapy or surgery followed by postoperative RT (PORT) with or without concurrent chemotherapy. Therefore treatment for T3/T4 HPC is challenging and optimal treatment choice is still controversial. The purpose of this study is to retrospectively evaluate and compare the survival outcomes for T3/T4 HPC patients treated with DRT and surgery followed by PORT. One hundred and thirteen consecutive patients with T3/T4 squamous cell carcinoma of the hypopharynx treated with DRT or surgery followed by PORT between 2000 and 2013 were retrospectively evaluated. Forty-two patients (37%) were treated with DRT and 71 (63%) were surgery followed by PORT. Sixty-one patients had T3, 40 had T4a, and 2 had T4b disease. Nine patients were stage III, 93 were IVA, and 11 were IVB. Median radiation dose for DRT and PORT group was 70 Gy (range: 50-70Gy) and 60 Gy (range: 46-70Gy), respectively. Concurrent chemotherapy was performed for 35 patients (83%) in DRT group and 35 patients (49%) in the PORT group. Median follow-up periods for all patients and surviving patients were 22.5 and 32 months, respectively. In DRT group, a total of 15 patients (36%) died. Thirteen (87%) died due to HPC and 2 (13%) due to other disease. In PORT group, a total of 37 patients (52%) died. Twenty-six (70%) died due to HPC and 11 (30%) due to other disease. Fourteen patients had local recurrence in definitive RT group and 7 of them received salvage surgery. Five of them (71%) achieved survive without any further recurrence. In PORT group, 1 patient had local recurrence without salvage surgery. Eight (19%) patients had distant metastases in DRT group and 22 (31%) in the PORT group. The 3- / 5-year overall survival (OS) rates for all patients were 52 / 45%. The 3- / 5-year OS rates for DRT group and PORT group were 42 / 24% and 54 / 52%, respectively (P=.45). The 3- / 5-year loco-regional control (LRC) rates for all patients were 70% / 68%. The 3- / 5-year LRC rates for DRT group and PORT group were 42% / 42% and 87% / 83%, respectively (P<.001). The 3-and 5-year distant metastasis free (DM) rates for all patients were 69% / 63%. The 3-and 5-year DM rates for DRT group and PORT group were 72% / 72% and 67% / 61%, respectively (P=.33). Better LRC rate was achieved in PORT group comparing to DRT group, however, OS rate was similar. This resulted from the higher occurrence rate of distant metastasis in PORT group because of the lower administration rate of chemotherapy. Salvage surgery contributes the improvement of OS rate in DRT group. Higher death rate due to other causes in PORT also correlated with these results. Larger and prospective studies will provide the best treatment strategy for T3/4 HPC with better survival outcomes." @default.
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• W2554639052 date "2015-11-01" @default.
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• W2554639052 title "Radiation Therapy for T3/T4 Squamous Cell Carcinoma of Hypopharynx: A Retrospective Comparison Between Definitive Radiation Therapy and Surgery Followed by Postoperative Radiation Therapy" @default.
• W2554639052 doi "https://doi.org/10.1016/j.ijrobp.2015.07.1416" @default.
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