Browse > Article

Effect of Induction Chemotherapy Followed by Radiation Therapy of Locally Advanced Hypopharyngeal Carcinoma  

Kim, Jae-Won (Department of Otolaryngology, College of Medicine, GyeongSang National University)
Son, Hee-Young (Department of Otolaryngology,, College of Medicine, GyeongSang National University)
Jeon, Sea-Yuong (Department of Otolaryngology, College of Medicine, GyeongSang National University)
Park, Jung-Je (Department of Otolaryngology, College of Medicine, GyeongSang National University)
Ahn, Seong-Ki (Department of Otolaryngology, College of Medicine, GyeongSang National University)
Kang, Ki-Mun (Department of Radiation Oncology, College of Medicine, GyeongSang National University)
Kim, Jin-Pyeong (Department of Otolaryngology, College of Medicine, GyeongSang National University)
Publication Information
Korean Journal of Head & Neck Oncology / v.24, no.1, 2008 , pp. 26-32 More about this Journal
Abstract
Purpose：Hypopharyngeal carcinoma is usually diagnosed as an advanced disease after an asymptomatic beginning, and it is related to a high frequency of lymph node metastases. An eventual negative outcome may occur not only because of possible locoregional failures but also for frequent distant metastases. Thus, the efficacy of induction chemotherapy followed by radiation therapy, with regards to the response, survival rate and complications for locally advanced hypopharyngeal carcinoma patients, was examined. Methods and Materials：Since July 1998 to February 2001, 18 patients having locally advanced hypopharyngeal carcinoma were treated with induction chemotherapy followed by radiation therapy, and the results were retrospectively analyzed. The regimen of the induction chemotherapy was the 5-flurouracil(5-FU, 1,000mg/$m^2$ daily for 5 consecutive days) and cisplatin(100mg/$m^2$ on day 1) combination at 3-week intervals for 2 cycles. The total radiation dose for the primary tumor and metastatic lymph nodes was 68.4-72.0Gy(median：70.2Gy) Results：The 3-year overall survival rate and disease free survival rate were 31.3% and 22.2%, respectively. In 6 patients(33.3%), preservation of the larynx for over 3 years was possible. After the induction chemotherapy and radiotherapy, a complete response was noted in 14 patients(77.8%), and a partial response in 4 patients (22.2%), with an overall response rate of 100%. Conclusion：Induction chemotherapy followed by radiation therapy is an effective treatment and larynx preservation rate was 33% in patients with locally advanced hypopharyngeal carcinoma in our report.
Keywords
Hypopharyngeal carcinoma; Chemotherapy; Radiation therapy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Barzan L, Talamini R, Politi D, Minatel E, Gobitti C, Franchin G: Squamous cell carcinoma of the hypopharynx treated with surgery and radiotherapy. J Laryngol Otol. 2002;116:24-28
2 Wolf GT, Hong WK, Department of Veterans Affairs Laryngeal Cancer Study Group: Induction chemotherapy as part of a new treatment strategy to preserve the larynx in advanced laryngeal cancer. In: Johnson JT, Didolkar MS, editors. Head and Neck cancer. Vol. 3. Amsterdam: Excerpta Medica, 1993:27-35
3 Wang SG, Lee BJ, Goh EK, et al: Neoadjuvant chemotherapy and radiotherapy for the treatment of hypopharyngeal cancer. Korean J Otolaryngol. 2003;46:1058-1063
4 Marks JE, Devineni VR, Harvey J, et al: The risk of contralateral lymphaticmetastases for cancers of the larynx and pharynx. Am J Otolaryngol. 1992;1:13-34
5 Million RR: Carcinomas of the larynx and hypopharynx: Curative treatment with preservation of laryngeal function. Front Radiat Ther Oncol. 1993;27:31-40
6 Frank JL, Grarb JL, Kay S, et al: Postoperative radiotherapy improve survival in squamous cell carcinoma of the hypopharynx. Am J Surg. 1994;168:476-480   DOI   ScienceOn
7 Kraus DH, Zelefsky MJ, Brock HA, et al: Combined surgery and radiation therapy for squamous cell carcinoma of the hypopharynx. Otolaryngol Head Neck Surg. 1997;116:637-641   DOI   ScienceOn
8 Zelefsky MJ, Kraus DH, Pfister DG, et al: Combined chemotherapy andradiotherapy versus surgery and postoperative radiotherapy for advanced hypopharyngeal cancer. Head Neck. 1996; 18:405-411   DOI   ScienceOn
9 Cox JD, Stetz J, Pajak TF: Toxicity criteria of the radiation therapy oncology group(RTOG) and the European organization for research and the treatment of cancer(EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341-1346   DOI   ScienceOn
10 Slotman BJ, Kralendonk JH, Snow GB, et al: Surgery and postoperative radiotherapy and radiotherapy alone in T3-T4 cancers of he pyriform sinus. Treatment results and patterns of failure. Acta Oncol. 1994;33:55-60   DOI
11 Desanto L, Lillie J, Devine K: Surgical salvage after radiation for laryngeal cancer. Laryngoscope. 1976;86:649-653   DOI   ScienceOn
12 Schantz SP, Harrison LB, Hong WK: Tumors of the nasal cavity and paranasal sinus, nasopharynx, oral cavity, and oropharynx, in: Devita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology. 4th ed. Philadelphia: Lippincott Co., 1993:574-630
13 Bahadur S, Thakar A, Mohanti BK, et al: Results of radiotherapy with, or without, salvage surgery versus combined surgery and radiotherapy in advanced carcinoma of the hypopharynx. J Laryngol Otol. 2002;116:29-32
14 Adjuvant chemotherapy for advanced head and neck squamous carcinoma: Final report of the Head and Neck Contracts Program. Cancer. 1987;60:301-311   DOI   ScienceOn
15 Pfister D, Strong E, Harrison L: Larynx preservation with combined chemotherapy and radiotherapy in advanced head and neck cancer. J Clin Oncol. 1991;9:830-859
16 Shirinian MH, Weber RS, Lippman SM, et al: Laryngeal preservation by induction chemotherapy plus radiotherapy in locally advanced head and neck cancer: The M.D. Anderson cancer center experiences. Head Neck. 1994:16:39-44   DOI   ScienceOn
17 Lefebvre JL. Larynx preservation: The discussion is not closed. Otolaryngol Head Neck Surg. 1998;118:389-393   DOI   ScienceOn
18 Wang CC: Carcinoma of the hypopharynx. In: Wang CC, ed. Radiation therapy for head and neck neoplasms: Indication, Techniques, and Results. Massachusetts: Year Book Medical Publishers Co., 1990:207-222
19 Marks JE, Kurnik B, Powers WE: Carcinoma of the pyriform sinus: Ananalysis of treatment results. Complications and patterns of failure. Cancer. 1978;41:1008-1015
20 Kim S, Wu HG, Heo DS, et al: Advanced hypopharyngeal carcinoma treatment results according to treatment modalities. Head Neck. 2001;23:713-717   DOI   ScienceOn
21 Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Colette L, Sahmoud T. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III Trial. J Natl Cancer Inst. 1996; 13:890-899
22 Karp DD, Vaughan CW, Carter R, et al: Larynx preservation using induction chemotherapy plus radiation therapy as an alternative to laryngectomy in advanced head and neck cancer. A long-term follow-up report. Am J Clin Oncol. 1991;14:273-279   DOI   ScienceOn
23 Kim KH, Sung MW, Koo JW, et al: Neoadjuvant chemotherapy and radiotherapy for the treatment of advanced hypopharyngeal carcinoma. Korean J Otolaryngol. 1997;40:429-434
24 Pingree TF, Davis RK, Reichman O, Derrick L: Treatment of hypopharyngeal carcinoma: a 10-year review of 1,362 cases. Laryngoscope. 1987;97:901-904
25 Axon PR, Woolford TJ, Hargreaves SP, Yates P, Birzgalis AR, Farrington WT. A comparison of surgery and radiotherapy in the management of postcricoid carcinoma. Clin Otolaryngol. 1997; 22:370-374   DOI   ScienceOn
26 The Department of Veterans Affairs Laryngeal Cancer Study Group: Induction chemotherapy plus radiation compared with surgery plus radiation compated with surgery plus radiation in patients with advanced cancer. N Engl J Med. 1991;324:1685-1690   DOI   ScienceOn
27 Goepfert H, Lindberg RD, Jesse RH: Combined laryngeal conservation surgery and irradiation: Can we expand the indication for conservation therapy? Otolaryngol Head Neck Surg. 1981;89:974   DOI
28 Spector JG, Sessions DG, Emami B, et al: Squamous cell carcinoma of the pyriform sinus: a nonrandomized comparison of the therapeutic modalities and long-term results. Laryngoscope. 1995; 105:397-406   DOI   ScienceOn
29 Hill BT, Price LA, MacRae K: Importance of priamry site in assessing chemotherapy response and 7-year survival data in advanced squamous cell carcinomas of the head and neck. J Clin Oncol. 1986;4:1340-1347   DOI
30 Shedon JM, Zelefsky MJ: Hypopharyngeal cancer. in: Leibel SA, Phillips TL, eds. Textbook of radiation oncology. 1st ed. Philadelphia, W.B. Saunders Co., 1998:477-496
31 Miller AB, Hoogstraten B, Ataquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981;47:207-214   DOI   ScienceOn
32 Kajanti M, Mantyla M: Carcinoma of the hypopharyx: a retrospective analysis of the treatment results over a 25-year period. Acta Oncologica. 1990;29:903-907   DOI
33 Kim WT, Ki YK, Nam JH, et al: The results of postoperative radiotherapy for hypopharyngeal carcinoma. J Korean oc Ther Radiol Oncol. 2000;18:244-250
34 Carpenter R, Desanto L: Cancer of the hypopharynx. Surg Clin North Am. 1977;57:7-23