Non-surgical combined modality treatments for laryngeal organ preservation in advanced hypopharyngeal carcinoma
10.3760/cma.j.issn.1673-0860.2014.07.007
- VernacularTitle:非手术综合治疗保留中晚期下咽癌患者喉器官的临床研究
- Author:
Xinxin ZHANG
1
;
Jialing WANG
;
Wenming WU
;
Lin MA
;
Mingbo LIU
;
Feifan ZHAO
;
Deliang HUANG
Author Information
1. 解放军总医院耳鼻咽喉头颈外科
- Keywords:
Hypopharyngeal neoplasms;
Carcinoma,squamous cell;
Combined modality therapy;
Radiotherapy conformal
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2014;49(7):558-563
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the treatment outcome,laryngeal preservation and side-effect in locally advanced hypopharyngeal carcinoma treated with combined Hilical tomotherapy (HT) or intensitymodulated radiotherapy (IMRT) and chemotherapy and/or EGFR inhibitor (Cetuximab or Nimotuzumab).Methods A total of 68 patients (20 cases with T1-2N1-3M0 and 48 cases with T3-4N1-3M0) with locally advanced hypopharyngeal cancer were treated individualy with non-surgical combined modality treatments including induction chemotherapy followed by concurrent chemoradiotherapy,induction chemotherapy followed by concurrent radiotherapy and EGFR inhibitor,concurrent chemoradiotherapy and EGFR inhibitor,and concurrent radiotherapy and EGFR inhibitor.HT was used in 40 patients and IMRT in 28 patients.Side-effects were evaluated with the established Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.Results The average follow-up time was 25.7 months (range 3-69 months).All patients completed the planned radiotherapy without treatment breaks,and 66 (97.0％) of 68 patients completed the planned chemotherapy.The 2-year and 3-year overall survival rates were 78.8％ and 64.7％ respectively,with an organ preservation rate of 84.2％.The most common side-effect greater than or equal to grade 3 was oropharyngeal mucositis.No patient dependent on a percutaneous gastrostomy and tracheostomy tube.Conclusion Hypopharyngeal carcinoma can be treated with non-surgical combined modality treatment including HT or IMRT,with a high laryngeal organ preservation rate and minimal toxicities.
