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Hypopharyngeal squamous cell carcinoma: Three‐dimensional or Intensity‐modulated radiotherapy? A single institution's experience
Author(s) -
Katsoulakis Evangelia,
Riaz Nadeem,
Hu Man,
Morris Luc,
Sherman Eric,
McBride Sean,
Lee Nancy
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25509
Subject(s) - medicine , hypopharyngeal cancer , radiation therapy , laryngectomy , surgery , induction chemotherapy , stage (stratigraphy) , retrospective cohort study , larynx , paleontology , biology
Objectives/Hypothesis Compare outcomes of hypopharyngeal carcinoma that received conventional radiotherapy versus intensity‐modulated radiotherapy (IMRT). Study Design Retrospective single‐institution trial. Methods Between April 1990 and May 2011, 100 patients with hypopharyngeal cancer underwent curative radiotherapy (RT) at our institution: 50 with IMRT and 50 with conventional RT. The median age was 63 years. There were 12 T1, 22 T2, 37 T3, and 28 T4 patients. The majority of patients (82%) had nodal disease: 54% N2 and 8% N3. The majority of patients (83%) received chemotherapy. Of the patients who received chemotherapy, 84% received a platinum‐based regimen. The median RT dose was 7,000 cGy. The majority of patients (62%) had prophylactic percutaneous endoscopic gastrostomy tube placement. Toxicities were reviewed. Local control (LC), locoregional control (LRC), freedom from distant metastasis (FFM) rates, functional larynx preservation (LP), laryngectomy‐free survival (LFS), and overall‐survival (OS) curves were generated using the Kaplan‐Meier method. The log‐rank test was used to test prognostic variables. Results With a median follow up of 48.4 months, the 3/5‐year LC, LRC, FFM, LP, LFS and OS rates were 74%/69%, 77%/74%, 70%/66%, 51%/29%, 49.6%/31.8%, and 49%/34%, respectively. The median OS was 2.9 years. The 3‐year LC rate for IMRT was 77% versus 81% for conventional RT ( P = .91); 3‐year LRC for IMRT was 85% versus 76% for conventional RT ( P = .32). There was no increased local failure with IMRT. There was no difference in the rate of stricture with IMRT (32%) versus conventional RT (25.3%) ( P = .86). Conclusions IMRT achieved comparable LC and LRC rates to conventional RT. Level of Evidence 4 Laryngoscope , 126:620–626, 2016