[Exclusive radiotherapy of pyriform sinus carcinomas. Retrospective analysis of 90 cases]

In the present study 90 patients affected with pyriform sinus carcinomas are analyzed. They underwent irradiation alone from 1970 to 1986. All cases were staged according to TNM criteria (UICC 1982): 7 were T1, 16 T2, 40 T3, 27 T4, 36 N0, 18 N1, 3 N2, 33 N3. Radiotherapy was performed with 60Co. In all cases doses of 60-70 Gy were delivered to T and N1 and doses of 45-50 Gy to N0. Locoregional control obtained in 35 patients (38.9%): 6/7 T1 (85.7%), 9/16 T2 (56.2%), 15/40 T3 (37.5%), 5/27 T4 (18.5%) and 20/36 N0, 8/18 N1, 1/3 N2, 6/33 N3. The overall and NED 3-year survival rates are 23.3% (21/90) and 20.0% (18/90), respectively; at 5 and 10 years all patients alive are NED, with survival rates of 12.2% (11/90) and 9.8% (5/51) respectively. Locoregional failures were observed in 12/35 cases (34.3%); 91% of them occurred within the first two years of follow up (mean: 10 months). Distant metastases appeared in 26/90 patients (28.9%) and secondary tumors occurred in 10/90 cases (11.1%). Our experience confirms radiotherapy to be an effective alternative treatment to surgery in the early stages (I-II) of pyriform sinus carcinomas, but no more than only a palliative treatment in stage III-IV cancers.