Preserving Laryngo-Esophageal Function in Patients With Hypopharyngeal Cancer Treated With Radiotherapy: Predictive Factors and Long-Term Outcomes

Cancer Med. 2024 Nov;13(21):e70374. doi: 10.1002/cam4.70374.

Abstract

Background: Functional outcomes after hypopharyngeal cancer (HPC) treatment have a significant effect on patients' quality of life and prognosis. This study aimed to identify the predictive factors associated with laryngo-esophageal dysfunction in patients with HPC who received definitive radiotherapy.

Methods: Patients with HPC treated with definitive intensity-modulated radiotherapy between 2007 and 2019 at our institution were retrospectively evaluated. Laryngo-esophageal dysfunction-free survival (LDFS) events were defined as local recurrence, laryngo-esophageal dysfunction (defined as tracheostomy or feeding tube dependence), or death from any cause.

Results: The median follow-up period was 61 months for the 80 patients included in the study. The 5-year LDFS rate was 47%. A clinical T4 stage and lower pretreatment prognostic nutritional index (PNI) were independently associated with a lower LDFS.

Conclusion: A clinical T4 stage and lower pretreatment PNI were identified as predictors of a lower LDFS after definitive radiotherapy for HPC.

Keywords: hypopharyngeal cancer; intensity‐modulated radiotherapy; laryngo‐esophageal dysfunction‐free survival; predictive factors; prognostic nutritional index.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Esophagus / radiation effects
  • Female
  • Follow-Up Studies
  • Humans
  • Hypopharyngeal Neoplasms* / mortality
  • Hypopharyngeal Neoplasms* / radiotherapy
  • Larynx / physiopathology
  • Larynx / radiation effects
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Nutrition Assessment
  • Prognosis
  • Quality of Life
  • Radiotherapy, Intensity-Modulated* / adverse effects
  • Radiotherapy, Intensity-Modulated* / methods
  • Retrospective Studies
  • Treatment Outcome