PURPOSE: We present our experience with irradiation alone or combined with neck dissection for AJCC T1-T2 pyriform sinus carcinoma and compare our results to those obtained with conservation surgery. METHODS AND MATERIALS: Seventy-three patients were treated between 1964 and 1990. All patients had a minimum of 2 years of follow-up; no patient was lost to follow-up. RESULTS: The 5-year rates of local control and ultimate local control were, for Stage T1 (17 patients), 88% and 94%; and for Stage T2 (56 patients), 79% and 91%. Patients with T2 lesions had a significantly higher rate of local control after twice-daily, compared with once-daily, irradiation (p = .04). However, a multivariate analysis of various parameters revealed that none of the variables tested significantly influenced this end point: vocal cord mobility (p = .15), once- vs. twice-daily fractionation (p = .33), T1 vs. T2 (p = .32), apex invasion (p = .58), and pretreatment CT scan (p = .67). Local control with laryngeal voice preservation was obtained in 88% of patients with T1 cancers and 80% of those with T2 cancers. Ultimate control above the clavicles at 5 years according to AJCC stage was as follows: I and II, 100%; III, 78%; IVA, 75%; and IVB, 60%. The probability of cause-specific survival at 5 years was as follows: I and II, 100%; III, 83%; and IVA and IVB, 51%. Overall, nine patients (12%) developed severe complications, one of which was fatal. CONCLUSION: Compared with available data from series using conservation surgery, radiotherapy alone or followed by neck dissection results in similar rates of local control and survival with a significantly lower risk of fatal complications.
PURPOSE: We present our experience with irradiation alone or combined with neck dissection for AJCC T1-T2 pyriform sinus carcinoma and compare our results to those obtained with conservation surgery. METHODS AND MATERIALS: Seventy-three patients were treated between 1964 and 1990. All patients had a minimum of 2 years of follow-up; no patient was lost to follow-up. RESULTS: The 5-year rates of local control and ultimate local control were, for Stage T1 (17 patients), 88% and 94%; and for Stage T2 (56 patients), 79% and 91%. Patients with T2 lesions had a significantly higher rate of local control after twice-daily, compared with once-daily, irradiation (p = .04). However, a multivariate analysis of various parameters revealed that none of the variables tested significantly influenced this end point: vocal cord mobility (p = .15), once- vs. twice-daily fractionation (p = .33), T1 vs. T2 (p = .32), apex invasion (p = .58), and pretreatment CT scan (p = .67). Local control with laryngeal voice preservation was obtained in 88% of patients with T1 cancers and 80% of those with T2 cancers. Ultimate control above the clavicles at 5 years according to AJCC stage was as follows: I and II, 100%; III, 78%; IVA, 75%; and IVB, 60%. The probability of cause-specific survival at 5 years was as follows: I and II, 100%; III, 83%; and IVA and IVB, 51%. Overall, nine patients (12%) developed severe complications, one of which was fatal. CONCLUSION: Compared with available data from series using conservation surgery, radiotherapy alone or followed by neck dissection results in similar rates of local control and survival with a significantly lower risk of fatal complications.
Authors: Ashok M Shenoy; T Shiva Kumar; V Prashanth; Purushotham Chavan; Rajshekar Halkud; Linu Jacob; K Govind Babu; G Lokesh; Tanveer Pasha; Rekha V Kumar Journal: Indian J Otolaryngol Head Neck Surg Date: 2012-01-06
Authors: Ezra E W Cohen; Daniel J Haraf; Marcy A List; Masha Kocherginsky; Bharat B Mittal; Fred Rosen; Bruce Brockstein; Rosalyn Williams; Mary Ellyn Witt; Kerstin M Stenson; Merrill S Kies; Everett E Vokes Journal: J Clin Oncol Date: 2006-07-20 Impact factor: 44.544