The Efficacy of Low Postoperative Radiation Dose in Patients with Advanced Hypopharyngeal Cancer without High-Risk Factors

• Main Authors: Tao H, Shen Z, Liu Z, Wei Y
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-08-01
• Series: Cancer Management and Research
• Subjects: head and neck cancer; hypopharyngeal squamous cell carcinoma; postoperative radiotherapy; quality of care.
• Online Access: https://www.dovepress.com/the-efficacy-of-low-postoperative-radiation-dose-in-patients-with-adva-peer-reviewed-article-CMAR

Hengmin Tao,1,2 Zhong Shen,1,2 Zhichao Liu,1,2 Yumei Wei1,2 1Department of Head and Neck Radiotherapy, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 2Key Laboratory of Otorhinolaryngology, National Health Commission (Shandong University), Jinan, People’s Republic of ChinaCorrespondence: Yumei Wei Email [e-mail]: To evaluate the feasibility and efficacy of low postoperative radiotherapy (PORT) dose in patients with advanced hypopharyngeal squamous cell carcinoma (HPSCC) and identify prognostic factors in this group.Patients and Methods: Between January 2013 and September 2015, 110 consecutive patients with HPSCC with no high-risk factors were treated postoperatively to 50 Gy (n=89), 56 Gy (n=12), and 60 Gy (n=9) in 2 Gy/fraction. Overall survival (OS), 3-year progression-free survival (PFS), 3-year loco-regional recurrence-free survival (LRFS), and treatment-related toxicities were analyzed.Results: Median follow-up time was 40 months (range=6– 75 months). The 3-year local-regional control (LRC) and 3-year neck control rate were 86.3% and 91.8%, respectively. The 3-year OS, PFS, and LRFS were 69.9%, 65.5%, and 80.5%, respectively. In a univariate analysis, T stage showed a significant correlation with improved OS, PFS, and LRFS (P=0.008, P=0.039, P=0.034). On multivariate analysis, T stage showed a significant correlation with improved OS and PFS. N stage showed a significant correlation with improved PFS. However, interval surgery-radiotherapy, reconstructive methods, and RT dose cannot serve as a significant prognostic factor for survival outcome.Conclusion: This study suggests that treating no high-risk factors for locally advanced HPSCC with a dose of 50 Gy to the whole operative bed and elective lymph node levels cannot compromise disease control and survival.Keywords: head and neck cancer, hypopharyngeal squamous cell carcinoma, postoperative radiotherapy, quality of care