Preoperative concurrent chemoradiotherapy versus pre- and postoperative radiotherapy for advanced hypopharyngeal carcinoma: A single-center study

Abstract

Objective The purpose of this study was to improve the survival and phonatory rates in patients with advanced hypopharyngeal carcinoma. Methods Seventy-two consecutive patients with advanced hypopharyngeal carcinoma were treated with pre- and postoperative radiotherapy (RTS), or preoperative concomitant chemoradiotherapy (CCRTS). Surgical procedures, including total laryngectomy plus partial pharyngectomy (TLPP) to preserve the posterior pharyngeal wall offering a functional neoglottis for esophageal or tracheoesophageal shunt phonation postoperatively, were conducted for patients who did not achieve CR. Results A significantly higher survival rate at 5 years (93.3%) was observed for N0-2b stage patients in the CCRTS group ( n = 16) than the RTS group ( n = 34; 41.5%) ( p < .005). The distant metastasis-free rate was 92.9% (CCRTS group) versus 55.4% (RTS group) ( p < .05) in these patients. In the CCRTS group, the 5-year survival rate with laryngeal or esophageal and/or tracheoesophageal shunt phonation was 22.2%. Conclusion It is suggested that the CCRTS protocol and TLPP procedure may improve the survival rates without deterioration of phonatory rates in patients with N0-2b advanced hypopharyngeal carcinoma.