OBJECTIVETo evaluate the treatment results of advanced pyriform sinus cancer according to therapy modalities.

METHODSTwo hundred and eighty seven patients with locally advanced pyriform sinus cancer were included in this retrospective analysis. One hundred and thirty four patients were treated with radiotherapy alone (Ra group) with 68.8 Gy. One hundred and twenty five patients were treated with preoperation radiotherapy with 45.5 Gy followed by surgery including 32 laryngeal function sparing surgery (R + S group). Thirteen patients were treated with surgery alone (Sa group). Fifteen patients were treated with surgery followed by post-operation radiotherapy with 56.3 Gy (S + R group) . There was no laryngeal function sparing surgery in the last two groups.

RESULTSSurvival rate and laryngeal sparing rate were calculated using Kaplan-Meier method. The overall 5-year survival rates were 23. 13% for Ra group, 46.51% for R + S group,18. 33% for Sa group and 44. 44% for S + R group, 46. 2% for combined therapy group ( R + S group and S + R group) and 22. 60% for single therapy group (Sa group and Ra group). There was statistical difference between combined therapy group and single therapy group (P = 0. 000 ) . Laryngeal sparing rate were 14. 08% ,13.61% , 0 and 0,respectively. R + S group showed superiority over Ra group, Sa group and S + R group in teams of both overall survival rate and laryngeal sparing rate. Laryngeal function spare was analyzed using Cox model. Therapy mode is the most important factor that contribute to laryngeal sparing. No significant differences were found in complication rate among the groups.

CONCLUSIONPreoperation radiotherapy conduce to preserve laryngeal function of patients with locally advanced pyriform sinus carcinoma.