Laser Debulking Surgery Prior to Radiotherapy for T2 Carcinoma of the Hypopharynx

Abstract

With treatments for T2 carcinoma of the hypopharynx, although the local control rate is rather high, overall survival is not satisfactory irrespective of treatment modalities. From the point of view of quality of life (QOL), for patients with a minor hypopharyngeal lesion, such as T1 T2 cases, radiotherapy has often been selected as a first choice instead of partial pharyngectomy. In our hospitals, laser debulking surgery has been employed prior to radiotherapy in order to improve local control and to conserve the patient's QOL, if the primary lesion is exophytic and high-volume. The purpose of this study is to present the results of laser debulking surgery prior to radiotherapy for T2 carcinoma of the hypopharynx.
The subjects were 26 T2 M0 patients (23 of piriform sinus type and 3 post-cricoid). Results showed, the 5-year local control rate, 5-year larynx conservation rate and disease-specific 5-year survival rate were 92%, 92% and 96%, respectively. However, the overall 5-year survival rate was only 61%. The patients' QOL was not aggravated either during the irradiation or after treatment. These findings suggest that this procedure may be preferable for selected cases with T2 carcinoma of the hypopharynx.