Induction Chemotherapy Followed by Radiotherapy for Stage IV Hypopharyngeal Cancer / 대한방사선종양학회지

ABSTRACT

PURPOSE: Hypopharyngeal cancer is diagnosed at the advanced stage in most cases, which the prognosis known to be poor. Thus, the efficacy of induction chemotherapy followed by radiotherapy, with regards to the response and survival rate for stage IV hypopharyngeal cancer patients, was examined. MATERIALS AND METHODS: From July 1998 to February 2000, 18 cases were diagnosedas AJCC stage IV hypopharyngeal cancer without distant metastasis. These patients were treated with induction chemotherapy followed by radiotherapy, and the results retrospectively analyzed. The regimen of the induction chemotherapy was the 5-FU and cisplatincombination, at 3-week intervals for, 2 cycles. The total radiation dose for the primary lesion and metastatic lymph nodes was 68.4~72.0 Gy (median 70.2 Gy). RESULTS: The median follow up period was 28 months, ranging from 7 to 99 months. The 3-year overall survival and disease-free survival rate were 41.7 and 31.1%, respectively. In 6 cases (33.3%), conservation of the larynx for over 3 years was possible. After the induction chemotherapy there were 16 partial responses (88.8%), 1 complete response and 1 with no response (5.6% each), therefore, 17 of the 18 cases (94.6%) showed responses. After the completion of the induction chemotherapy and radiotherapy, a complete response was noted in 13 cases (72.2%), a partial response in 5 (27.8%), with an overall response rate of 100%. In the analysis of the prognostic factors influencing the survival rate, the 3-year and disease-free survival rates for the complete and partial response groups were 43.1, and 20.0%, and 39.6, and 20.0%, respectively (p=0.0003, p=0.002). Only the final response after treatment completion was statistically significant. CONCLUSION: For stage IV hypopharyngeal cancer, induction chemotherapy followed by radiotherapy was an effective treatment, with no severe side effects.