Hypopharyngeal cancer is the second most common of the head and neck cancers in Japan. We retrospectively analyzed 77 fresh cases of hypopharyngeal cancer who were treated in our department between 2005 and 2013. They were 69 males and 8 females, aged 49 to 81 years with an average of 65.3 years.
Our treatment protocol was as follows: For T1/2 cancers, hyperfractionated radiotherapy with concurrent daily carboplatin (25 mg/m²) was performed. Responders at 30–40 Gy continued receiving chemoradiotherapy to a total of 72 Gy whereas nonresponders underwent surgery. For T3/4 cancers, 1–2 courses of induction chemotherapy (docetaxel 60 mg/m² [day 1], cisplatin 60 mg/m² [day 1], and 5-fluorouracil 600 mg/m² [days 1–5]) were performed. Responders of T3 patients and good responders of T4 patients were then given chemoradiotherapy whereas the other T3/4 patients underwent surgery after induction chemotherapy.
The overall 5-year crude and disease-specific survival rates determined by the Kaplan-Meier method were 58.0% and 68.1%, respectively. The survival rates were significantly higher in patients at stage II/III than in those at stage IV. The overall laryngeal preservation rate after primary treatment was 58.4%. The laryngeal preservation rate was significantly higher in patients of T1/2 than in those of T3/4 (T1: 100%, T2: 93.3%, T3: 53.3%, T4: 25.8%). The survival rate of T3/4 patients did not differ between the laryngeal preservation and removal groups.
The overall survival and laryngeal preservation rates could be improved by the early detection of hypopharyngeal cancers and by altering the treatment protocol for advanced cancers.