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- Title
Retrospective analysis of the clinical efficacy of definitive chemoradiotherapy for patients with hypopharyngeal cancer.
- Authors
Keiichi Takehana; Takeshi Kodaira; Hiroyuki Tachibana; Kana Kimura; Arisa Shimizu; Chiyoko Makita; Natsuo Tomita; Daisuke Nishikawa; Hidenori Suzuki; Hitoshi Hirakawa; Nobuhiro Hanai; Yasuhisa Hasegawa
- Abstract
Objective: A retrospective analysis was performed to evaluate the clinical efficacy of definitive chemoradiotherapy including intensity-modulated radiotherapy for patients with hypopharyngeal cancer. Methods: Previously untreated 204 patients with hypopharyngeal cancer were treated with definitive chemoradiotherapy. Of note, 66-70 Gy was delivered to the primary and involved nodes and 36-54 Gy was delivered to the prophylactic lymph node using standard fractionated radiotherapy. One hundred and forty-six patients received induction chemotherapy as a larynx preservation strategy, followed by definitive radiotherapy with or without concurrent chemotherapy. Intensitymodulated radiotherapy was also performed after 2006. Results: The median follow-up time of this cohort was 43.4 months (range; 6.9-151.0). The 3-year overall survival, progression-free survival and larynx preservation survival rates were 78.8% (95% confidence interval; 73.0-85.0), 58.4% (95% confidence interval; 51.8-65.9) and 67.5% (95% confidence interval; 61.0-74.7), respectively. Multivariate analyses identified the following significant prognostic factors: an advanced age, the T category and N category for overall survival, the T category and N category for progression-free survival and the T category for larynx preservation survival. Acute toxicities of Grade 3 or higher were observed in 47 patients (23.0%). Two patients (1.0%) had Grade 4 pharyngeal edema. Suspicious treatment-related death due to lethal pharyngeal hemorrhage occurred in 1 (0.4%) patient. The rates of Grade 2 xerostomia in patients treated with intensity- modulated radiotherapywere 28.1, 17.4 and 9.5% at 6 months, 1 and 2 years after the completion of radiotherapy, respectively. Conclusions: The efficacy and safety of definitive chemoradiotherapy are considered feasible with sufficient laryngeal preservation.
- Publication
Japanese Journal of Clinical Oncology, 2016, Vol 46, Issue 4, p344
- ISSN
0368-2811
- Publication type
Article
- DOI
10.1093/jjco/hyv216