OBJECTIVETo compare the surgery complications and laryngeal function sparing rate after preoperative concurrent chemoradiotherapy and preoperative radiotherapy of pyriform sinus cancer.

METHODSForty-six patients with squamous cell carcinoma of pyriform sinus from March 2002 to March 2009 were retrospectively analyzed. Concurrent chemotherapy with radiotherapy (CRT + S group) was conducted in twenty-three patients. Cisplatin (50 mg/weekly) was mostly applied. Twenty-three patients were treated with radiation only (RT + S group). Surgery was conducted after a break-time of 21 - 44 days (median, 31 d) and 17 - 40 days (median, 28 d), respectively.

RESULTSThe complication rate of CRT + S group and RT + S group were 30.4% and 39.1% respectively, no significant differences was found (χ(2) = 0.099, P < 0.05). The one-year laryngeal function sparing rate of the two groups were 52.2% and 17.4% respectively, with significant differences (χ(2) = 6.133, P < 0.05). The one-year local regional control rate and disease free survival rate for the CRT + S group were 89.9%, 71.1%, and for RT + S group were 56.3%, 47.1%, P level were 0.018 and 0.037, respectively. There was significant differences in one year local regional control rate and disease free survival rate between the two groups.

CONCLUSIONThe addition of concurrent chemotherapy to preoperative radiotherapy in patients with pyriform sinus cancer does not increase the incidence of surgery complications. Chemotherapy improves the remission rate and appears to increase the laryngeal function sparing rate. Preoperative concurrent chemoradiotherapy can improve the local and regional control, and certainly, more investigations will be needed.