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Concomitant chemoradiotherapy in pyriform sinus carcinoma
Jean-Michel Prades1, Thierry M Schmitt, Andrei P Timoshenko
1Department of Otolaryngology, Head and Neck Surgery, Bellevue Hospital, St-Etienne University Hospital Center, Boulevard Pasteur, 42055 Saint-Etienne CEDEX 2, France.
Archives of Otolaryngology--Head & Neck Surgery
|April 3, 2002
Summary
Concurrent chemoradiotherapy shows promise for pyriform sinus carcinoma, enabling laryngeal preservation. While toxic, this approach offers good locoregional control for organ preservation in advanced cases.
Area of Science:
- Oncology
- Radiation Oncology
- Head and Neck Cancer
Background:
- Pyriform sinus carcinoma presents a significant challenge in head and neck oncology.
- Organ preservation strategies are crucial for maintaining quality of life in patients.
Purpose of the Study:
- To evaluate the efficacy of concurrent chemoradiotherapy for pyriform sinus carcinoma.
- To assess the feasibility of an organ preservation approach in these patients.
Main Methods:
- A Phase 2 clinical trial involving 46 male patients with resectable stage III and IV pyriform sinus carcinoma.
- Two chemoradiation protocols were compared: Protocol 1 (carboplatin + bifractionated radiotherapy) and Protocol 2 (carboplatin + fluorouracil + conventional radiotherapy).
- Outcomes assessed included tumor response, toxic reactions, organ preservation, and survival rates using Kaplan-Meier analysis.
Main Results:
- Complete response rates were 88% for Protocol 1 and 73% for Protocol 2.
- Laryngeal preservation without disease was achieved in 67% (Protocol 1) and 55% (Protocol 2) of patients at 2 years.
- Toxicities led to unplanned hospitalizations in 63% (Protocol 1) and 86% (Protocol 2) of patients.
Conclusions:
- Concurrent chemoradiotherapy, particularly with bifractionated radiotherapy, demonstrates effective locoregional control for pyriform sinus carcinoma.
- This approach facilitates a significant level of laryngeal preservation, offering a viable organ preservation strategy.
- Despite toxicity, the benefits of locoregional control and organ preservation warrant consideration in treatment planning.