Concomitant radiochemotherapy for larynx preservation treatment in patents with locoregionally advanced squamous cell hypopharyngeal cancer

Laryngopharygectomy followed by radiotherapy or radiochemotherapy has been a standard treatment for patients with advanced hypopharyngeal cancer These treatment modalities lead to permanent tracheostomy, which has a negative influence on the quality of life. For this reason new treatment methods have been investigated for a number of years. The aim of the study. To evaluate the results and the toxicity of larynx preservation treatment for locally advanced squamous cell hypopharyngeal cancer. Material and methods. Between December 2004 and January 2007 56 patients with confirmed squamous cell hypopharyngeal cancer (stage III and IVa ) were treated with concomitant radiochemotherapy with an intention to preserve the larynx. Conformal 3D radiotherapy was applied in all cases. Chemotherapy consisted of cisplatin 100 mg/m2 per die administered twice during irradiation (day 1 and 22, day 43 of treatment) or once a week (35 mg/m2). Results. Median follow-up is 32 months. 5-year OS is 72%, DFS - 57%c, 3-year laryngectomy-free survival - LFS is 72%, 5-year LFS - 68% of patients (alive with larynx preservation). 11 patients have been diagnosed with local recurrence, 3 patients with nodal failure and one with locoregional failure. No severe life-threatening early and late complications were observed. Only 2 patients required temporary tracheostomy because of dyspnea due to laryngeal edema. Conclusion. We conclude that organ-preservation treatment is a valuable alternative to surgical treatment in patients diagnosed with stage III and IVa laryngeal and hypopharyngeal cancer. (authors)