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

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.

• Authors: Mitsuhiko Kawashima, Ryuichi Hayashi, Makoto Tahara, Satoko Arahira, Masakazu Miyazaki, Minoru Sakuraba, Sadamoto Zenda, Takashi Ogino
• Journal: Head & neck (Head Neck) Vol. 34 Issue 10 Pg. 1363-8 (Oct 2012) ISSN: 1097-0347 [Electronic] United States
• PMID: 22076936 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2011 Wiley Periodicals, Inc.

Chemical References

• Cisplatin
• Fluorouracil

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biopsy, Needle
• Carcinoma, Squamous Cell (mortality, pathology, 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, pathology, therapy)
• Humans
• Hypopharyngeal Neoplasms (mortality, pathology, therapy)
• Immunohistochemistry
• Larynx (drug effects, 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