Abstract
Objectives: The purposes were to evaluate the efficacy and toxicity of concurrent chemoradiotherapy (CCR) in patients with resectable squamous cell carcinoma (SCC) of the hypopharynx and to assess the feasibility of larynx preservation.
Patients and Methods: Forty-three eligible patients were treated with two chemotherapy regimens between October 1998 and July 2004. One of the chemotherapy regimens consisted of a combination of four drugs: cisplatin, 5-fluorouracil, methotrexate and leucovorin (CF-MTX-LV). The other regimen consisted of two drugs (carboplatin and UFT: CBDCA-UFT) for elderly cases or cases with complications. Radiotherapy was delivered 5 days a week using a single daily fraction of 1.8 to 2.0 Gray, to a total dose of 70 Gray.
Results: The 5-year disease-specific survival and the 5-year disease-specific survival with larynx preservation of cases receiving CF-MTX-LV were 73.3% and 56.4%, respectively. The 3-year disease-specific survival and the 3-year disease-specific survival with larynx preservation of cases receiving CBDCA-UFT were 30.5% and 15.2%, respectively. The main toxicities in these CCR modalities were neutropenia, dermatitis, mucositis, infection and nausea/vomiting.
Conclusion: It was thought that the adverse events appeared strongly in the CF-MTX-LV treatment group, and the intensive care was necessary for management. In terms of larynx preservation, the present regimens appeared to be useful for selective patients with resectable SCC of the hypopharynx.
