BACKGROUND: Pyriform sinus squamous cell carcinoma (SCC) has one of the worst prognoses of all upper aerodigestive tract cancers. Improving clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists. METHODS: We investigated 30 patients with pyriform sinus SCC to verify the effectiveness of weekly cisplatin chemotherapy with concurrent radiotherapy. Cisplatin was administered at a dose of 40 mg/m(2) on weeks 1, 2, 3, 5, 6, and 7 during definitive radiotherapy with the aim of preserving the larynx. RESULTS: All 30 patients achieved definitive radiotherapy at a median dose of 70 Gy (range 64-70 Gy). Cisplatin was administrated concomitantly a median of five times (range 2-6 times). Persistent or recurrent primary disease was observed in four patients (13 %). Persistent or recurrent nodal metastasis was observed in five patients (17 %). Nine salvage surgeries were performed for eight patients, of whom seven survived without any evidence of disease. Post-operative complications were observed in two patients (22 %). The 5-year overall survival and locoregional control rates were 87 and 96 %, respectively. The 5-year laryngeal preservation rate was 74 %. CONCLUSIONS: The regimen of weekly cisplatin CRT may be effective for pyriform sinus SCC; however, there were problems with strong selection bias in the current study due to the large number of T2 patients. Salvage surgery was safe and was able to improve the survival rate. This chemoradiation regimen was considered successful in preserving laryngeal function.
BACKGROUND: Pyriform sinus squamous cell carcinoma (SCC) has one of the worst prognoses of all upper aerodigestive tract cancers. Improving clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists. METHODS: We investigated 30 patients with pyriform sinus SCC to verify the effectiveness of weekly cisplatin chemotherapy with concurrent radiotherapy. Cisplatin was administered at a dose of 40 mg/m(2) on weeks 1, 2, 3, 5, 6, and 7 during definitive radiotherapy with the aim of preserving the larynx. RESULTS: All 30 patients achieved definitive radiotherapy at a median dose of 70 Gy (range 64-70 Gy). Cisplatin was administrated concomitantly a median of five times (range 2-6 times). Persistent or recurrent primary disease was observed in four patients (13 %). Persistent or recurrent nodal metastasis was observed in five patients (17 %). Nine salvage surgeries were performed for eight patients, of whom seven survived without any evidence of disease. Post-operative complications were observed in two patients (22 %). The 5-year overall survival and locoregional control rates were 87 and 96 %, respectively. The 5-year laryngeal preservation rate was 74 %. CONCLUSIONS: The regimen of weekly cisplatin CRT may be effective for pyriform sinus SCC; however, there were problems with strong selection bias in the current study due to the large number of T2 patients. Salvage surgery was safe and was able to improve the survival rate. This chemoradiation regimen was considered successful in preserving laryngeal function.
Authors: J L Lefebvre; D Chevalier; B Luboinski; A Kirkpatrick; L Collette; T Sahmoud Journal: J Natl Cancer Inst Date: 1996-07-03 Impact factor: 13.506
Authors: M Al-Sarraf; M LeBlanc; P G Giri; K K Fu; J Cooper; T Vuong; A A Forastiere; G Adams; W A Sakr; D E Schuller; J F Ensley Journal: J Clin Oncol Date: 1998-04 Impact factor: 44.544
Authors: Jean-Michel Prades; Thierry M Schmitt; Andrei P Timoshenko; Pierre-Gilles Simon; Joanne de Cornulier; Marc Durand; Aline Guillot; Christian Martin Journal: Arch Otolaryngol Head Neck Surg Date: 2002-04
Authors: Mitchell Machtay; Jennifer Moughan; Andrew Trotti; Adam S Garden; Randal S Weber; Jay S Cooper; Arlene Forastiere; K Kian Ang Journal: J Clin Oncol Date: 2008-06-16 Impact factor: 44.544
Authors: David J Adelstein; Yi Li; George L Adams; Henry Wagner; Julie A Kish; John F Ensley; David E Schuller; Arlene A Forastiere Journal: J Clin Oncol Date: 2003-01-01 Impact factor: 44.544