Prospective trial of chemotherapy-enhanced accelerated radiotherapy for larynx preservation in patients with intermediate-volume hypopharyngeal cancer

Head Neck. 2012 Oct;34(10):1363-8. doi: 10.1002/hed.21934. Epub 2011 Nov 11.

Abstract

Background: Altered fractionation radiotherapy (RT) improves locoregional control in head and neck cancer without aggravation of late adverse events. To improve successful larynx-preservation rates in patients with resectable, intermediate-volume hypopharyngeal cancer, a prospective trial of chemotherapy-enhanced accelerated RT was conducted.

Methods: Patients with T2 to T4 hypopharyngeal cancer received 40 Gray (Gy)/4 weeks to the entire neck followed by boost RT administering 30 Gy/2 weeks (1.5 Gy twice-daily fractionation). Cisplatin and 5-fluorouracil were administered concomitantly only during boost RT.

Results: Thirty-five patients were enrolled in this study. All patients completed this protocol as planned. After a median follow-up period for surviving patients of 59 months (24-90 months), overall survival and local control rates at 3 years were 91% (95% confidence interval, 81% to 100%), and 88% (79% to 99%), respectively. All surviving patients maintained normalcy of diets.

Conclusion: This regimen was feasible with encouraging oncological and functional outcomes.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biopsy, Needle*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemotherapy, Adjuvant
  • Cisplatin / therapeutic use
  • Combined Modality Therapy
  • Disease-Free Survival
  • Dose Fractionation, Radiation*
  • Female
  • Fluorouracil / therapeutic use
  • Follow-Up Studies
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Hypopharyngeal Neoplasms / mortality
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / therapy*
  • Immunohistochemistry
  • Larynx / drug effects
  • Larynx / radiation effects
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prospective Studies
  • Radiotherapy Dosage
  • Salvage Therapy*
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Time Factors
  • Treatment Outcome
  • Tumor Burden

Substances

  • Cisplatin
  • Fluorouracil