Prognostic factor of severe complications in patients with hypopharyngeal cancer with primary concurrent chemoradiotherapy.

Abstract

BACKGROUND/AIM: Organ-preservation treatment for hypopharyngeal cancer has recently become a popular treatment option. However, the severe complications and poor quality of life after non-surgical treatment should be avoided. We accessed the laryngeal or pharyngeal dysfunction-related complications after concurrent chemoradiotherapy (CCRT) as the primary treatment for hypopharyngeal cancer. PATIENTS AND METHODS: Data concerning all patients treated for hypopharyngeal cancer with primary non-surgical treatment at the China Medical University Hospital from 2002 to 2012 were retrospectively reviewed. RESULTS: A total of 161 patients were included with a median age of 56.6 years. The disease control rates (disease-free >12 months) and severe complication rates were correlated to the tumor (T) stage and nodal (N) stage. In the successful treatment group, the complication rate was related to the N stage. The overall pharyngeal dysfunction, laryngeal dysfunction and aspiration rates were 36%, 27% and 25%, respectively. For patients with T4a disease, hyoid bone invasion significantly increased the severe complication rate (p=0.0212). CONCLUSION: The treatment outcome was correlated to the T and N stage. A higher rate of laryngopharyngeal dysfunction occurred when treating hyoid bone invasion in T4a patients with primary non-surgical treatment. In advanced stage, but still resectable hypopharyngeal tumors, the poorer quality of life due to non-function larynx was noted after treating with CCRT.