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Induction chemotherapy-based larynx preservation program for locally advanced hypopharyngeal cancer: oncologic and functional outcomes and prognostic factors

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Abstract

To evaluate oncologic and functional outcomes and prognostic factors in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program in daily clinical practice. All patients with locally advanced (T3/4, N0–3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngo-laryngectomy, treated by docetaxel (75 mg/m2, day 1), cisplatin (75 mg/m2, day 1) and 5-fluorouracil (750 mg/m2/day, day 1–5) (TPF)-ICT (2–3 cycles) for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Prognostic factors of oncologic (overall, cause-specific and recurrence-free survival: OS, SS and RFS) and functional (dysphagia outcome and severity scale, permanent enteral nutrition, larynx preservation) outcomes were assessed in univariate and multivariate analyses. A total of 53 patients (42 men and 11 women, mean age 58.6 ± 8.2 years) were included in this study. Grade 3–4 toxicities were experienced by 17 (32 %) patients during ICT. The rate of poor response (response <50 % without larynx remobilization) to ICT was 10 %. At 5 years, OS, SS and RFS rates were 56, 60 and 54 %, respectively. Four patients required definitive enteral nutrition (permanent enteral tube feeding). The rate of patients alive, disease-free and with a functional larynx at 2 years was 58 %. T4 tumor stage (p = 0.005) and response to ICT <50 % (p = 0.02) were independent prognostic factors of OS. Response to ICT was significantly associated with the risk of permanent enteral nutrition (p = 0.04) and larynx preservation (p = 0.01). In daily clinical practice, a TPF-ICT-based larynx preservation protocol can be used in patients with locally advanced hypopharyngeal cancer with satisfactory results in terms of tolerance, efficacy and oncologic and functional outcomes.

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Authors and Affiliations

  1. Institut Universitaire de la Face et du Cou, 31 avenue de Valombrose, 06103, Nice, France

    Alexandre Bozec, Clair Vandersteen, Olivier Dassonville, Gilles Poissonnet, Jean-Christophe Riss, François Demard & José Santini

  2. Department of Radiotherapy, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06103, Nice, France

    Karen Benezery, Jean-Michel Hannoun-Lévi, Marie-Eve Chand & Axel Leysalle

  3. Department of Statistics, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06103, Nice, France

    Marc Ettaiche & Emmanuel Chamorey

  4. Department of Medical Oncology, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06103, Nice, France

    Esma Saada, Joël Guigay & Frédéric Peyrade

  5. Department of Pathology, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06103, Nice, France

    Anne Sudaka

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  1. Alexandre Bozec
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  2. Karen Benezery
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  3. Marc Ettaiche
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  4. Emmanuel Chamorey
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  14. Anne Sudaka
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  15. François Demard
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Correspondence to Alexandre Bozec.

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Bozec, A., Benezery, K., Ettaiche, M. et al. Induction chemotherapy-based larynx preservation program for locally advanced hypopharyngeal cancer: oncologic and functional outcomes and prognostic factors. Eur Arch Otorhinolaryngol 273, 3299–3306 (2016). https://doi.org/10.1007/s00405-016-3919-3

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  • DOI: https://doi.org/10.1007/s00405-016-3919-3

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