Definitive radiotherapy for squamous cell carcinoma of the pyriform sinus

Radiother Oncol. 2012 Nov;105(2):232-7. doi: 10.1016/j.radonc.2012.09.004. Epub 2012 Oct 12.

Abstract

Background and purpose: To report the long-term results after definitive radiotherapy (RT) for pyriform sinus squamous cell carcinoma (SCC).

Material and methods: The data concerning all patients treated for pyriform sinus SCC with RT with a curative intent between 1990 and 2006 were reviewed.

Results: A total of 249 patients were included. The median follow-up is 6.5 years. Overall 123 patients had relapsed. For the entire population, the 5-year local control, regional control, freedom-from-distant metastasis, and overall survival rate were 68%, 69%, 78% and 38%, respectively. The 5-year local control rate for the 107 T1-T2 tumors was 85% (95% confidence interval (CI): 75-91). N stage was the main risk factor for the development of distant metastases, with a hazard ratio of 8.9 (95% CI: 2.1-39) and 15.6 (95% CI: 3.6-67.8) for N2 and N3 patients respectively. For patients with N2-N3 disease, pre-RT neck dissection improved regional control but not overall survival. Moderate to severe late complications occurred in 50 patients (28% of the patients without local relapse).

Conclusion: A high local control rate can be achieved when treating T1-T2 hypopharynx cancers with definitive radiotherapy. The high rate of nodal and distant relapses among patients with N2-N3 disease warrants intensification of therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Female
  • Humans
  • Hypopharyngeal Neoplasms / mortality
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Pyriform Sinus*