Failure patterns and outcomes after induction chemotherapy followed by radical radiotherapy in patients with locally advanced hypopharyngeal carcinoma
10.3760/cma.j.cn112271-20220116-00020
- VernacularTitle:局部晚期下咽癌患者诱导化疗联合根治性放疗后复发模式及生存分析
- Author:
Dan ZHAO
1
;
Meng WAN
;
Weixin LIU
;
Xiaolong XU
;
Baomin ZHENG
;
Shaowen XIAO
;
Shunyu GAO
;
Bin ZHANG
;
Weihu WANG
;
Yan SUN
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所放射治疗科 恶性肿瘤发病机制及转化研究教育部重点实验室，北京 100142
- Keywords:
Chemotherapy;
Hypopharyngeal neoplasms;
Prognosis;
Radiotherapy;
Recurrence
- From:
Chinese Journal of Radiological Medicine and Protection
2022;42(5):348-354
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the failure patterns and outcomes of patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) after undergoing induction chemotherapy (IC) followed by definitive radiotherapy.Methods:For patients with locally advanced HPSCC who were treated with IC and definitive radiotherapy from August 2008 to December 2019, their data were collected from the medical records system, and their clinical characteristics, failure patterns, and survival were retrospectively analyzed.Results:A total of 116 eligible patient with squamous cell carcinoma were included in this study. with a median age of 59 (39-79), and 3, 3, 60, and 50 of them had stage Ⅱ, Ⅲ, Ⅳ A, and Ⅳ B HPSCC, respectively. Among these patients, 81 received 1~2 cycles of IC, and 35 received 3-4 cycles of IC. After treatment with IC, 54, 13, and 49 patients received concurrent chemoradiotherapy, radiotherapy combined with targeted therapy, and radiotherapy alone, respectively. The median follow-up was 34.6 months (95% CI: 28.7-40.5 months). The 3-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), metastasis-free survival (MFS), progression-free survival (PFS), and overall survival (OS) of all the patients were 63.5%, 82.8%, 75.2%, 47.3%, and 43.1%, respectively. Median PFS and OS were 26.1 and 28.0 months, respectively. Treatment failure was reported in 59 patients, of whom 22, 5, 12, 10, 3, 6 and 1 experienced local, regional, distant only, local-regional, regional-distant, local-distant, and local-regional-distant failure, respectively. The objective response rate (CR+ PR) of patients after IC was 55.2% (64/116). The LRFS, RRFS, PFS, and OS of IC responders (CR+ PR) were better than those of IC non-responders (SD+ PD) ( χ2 = 12.52, 5.16, 13.19, 11.72, all P< 0.05). Conclusions:IC combined with radical radiotherapy has efficacy to a certain extent in the treatment of locally advanced HPSCC, and locoregional recurrence predominates the failure patterns. The prognosis of IC responders is significantly better than that of IC non-responders.
