Radiotherapy in the treatment of stage III-IV hypopharyngeal carcinoma

Background: The aim of this study was to evaluate the role of radiation therapy alone, employing standard fractionation, in stage III-IV hypopharyngeal carcinoma. Materials and Methods. Fourteen (38.9%) stage III and 22 (61.1%) stage IV patients with hypopharyngeal carcinoma were submitted, with curative intent, to exclusive radiotherapy to the primary tumor and regional draining lymph nodes, level II, III, IV, V and VI. Total dose ranged from 68 to 72 Gy. Results: The 5-year overall survival (OS) and disease-specific survival (DSS) rates were 15.6% and 28.1%, respectively. Five-year OS in stage III and IV patients was, respective, 33% and 5% (p=0.028) and DSS was, respectively, 50% and 16% (p=0.029). Five-year OS and DSS rate in N0 versus N+ patients were respective 37.5% and 75% versus 8.3% and 12.5% (p=0.07 and p=0.05). Conclusion: Overall survival at 5 years for III-IV hypopharyngeal tumor treated with radiotherapy alone is poor. It is possible that the addition of the best radiation fractionation to the best concurrent chemotherapy may improve the results, with acceptable toxicity.