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. Intensity-modulated 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 radiotherapy were 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.
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. Intensity-modulated 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 radiotherapy were 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.
Authors: Arlene A Forastiere; Helmuth Goepfert; Moshe Maor; Thomas F Pajak; Randal Weber; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; Clifford Chao; Glen Peters; Ding-Jen Lee; Andrea Leaf; John Ensley; Jay Cooper Journal: N Engl J Med Date: 2003-11-27 Impact factor: 91.245
Authors: Gregory T Wolf; Susan Gross Fisher; Waun Ki Hong; Robert Hillman; Monica Spaulding; George E Laramore; James W Endicott; Kenneth McClatchey; William G Henderson Journal: N Engl J Med Date: 1991-06-13 Impact factor: 91.245
Authors: J-L Lefebvre; G Andry; D Chevalier; B Luboinski; L Collette; L Traissac; D de Raucourt; J A Langendijk Journal: Ann Oncol Date: 2012-04-06 Impact factor: 32.976
Authors: J L Lefebvre; F Rolland; M Tesselaar; E Bardet; C R Leemans; L Geoffrois; P Hupperets; L Barzan; D de Raucourt; D Chevalier; L Licitra; F Lunghi; R Stupp; D Lacombe; J Bogaerts; J C Horiot; J Bernier; J B Vermorken Journal: J Natl Cancer Inst Date: 2009-01-27 Impact factor: 13.506
Authors: Marshall R Posner; Diane M Hershock; Cesar R Blajman; Elizabeth Mickiewicz; Eric Winquist; Vera Gorbounova; Sergei Tjulandin; Dong M Shin; Kevin Cullen; Thomas J Ervin; Barbara A Murphy; Luis E Raez; Roger B Cohen; Monica Spaulding; Roy B Tishler; Berta Roth; Rosana del Carmen Viroglio; Varagur Venkatesan; Ilya Romanov; Sanjiv Agarwala; K William Harter; Matthew Dugan; Anthony Cmelak; Arnold M Markoe; Paul W Read; Lynn Steinbrenner; A Dimitrios Colevas; Charles M Norris; Robert I Haddad Journal: N Engl J Med Date: 2007-10-25 Impact factor: 91.245
Authors: Randal S Weber; Brian A Berkey; Arlene Forastiere; Jay Cooper; Moshe Maor; Helmuth Goepfert; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; K S Clifford Chao; Glenn Peters; D J Lee; Andrea Leaf; John Ensley Journal: Arch Otolaryngol Head Neck Surg Date: 2003-01
Authors: Arlene A Forastiere; Qiang Zhang; Randal S Weber; Moshe H Maor; Helmuth Goepfert; Thomas F Pajak; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; Wade Thorstad; Henry Wagner; John F Ensley; Jay S Cooper Journal: J Clin Oncol Date: 2012-11-26 Impact factor: 44.544