Long-term Clinical Evaluation of Intra-arterial Chemoradiotherapy for the Treatment of Stage III and IV Hypopharyngeal Carcinoma

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  • 下咽頭癌stage III・IV症例に対する超選択的動注による臓器・機能温存療法の長期的観察
  • カイントウ ガン stage Ⅲ ・ Ⅳ ショウレイ ニ タイスル チョウセンタクテキドウ チュウ ニ ヨル ゾウキ ・ キノウ オンゾン リョウホウ ノ チョウキテキ カンサツ

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Abstract

<p>Objectives: We reviewed a study of superselective intra-arterial and systemic chemoradiotherapy for the treatment of advanced hypopharyngeal carcinoma conducted between 2000 and 2008 to evaluate the long-term survival and preservation of organ function after this treatment.</p><p>Subjects and Methods: The patients averaged 62.8 years of age, ranging from 42 to 78 years. Three had stage III disease and 25 had stage IV disease. All the patients underwent superselective intra-arterial docetaxel infusion and systemic cisplatin and 5-FU chemotherapy. During and following the chemotherapy, all the patients received radiotherapy. We determined the rates of laryngeal preservation and the need for a tracheotomy or gastrostomy, and we reviewed the videofluoroscopic examination, videoendoscopy, and capsaicin test results. We also conducted a questionnaire.</p><p>Results: No major complications were observed in this series. For patients with primary lesions, the CR rate was very high (96.4%). The overall 5-year survival rate was 36.4%. The cause-specific 5-year survival rate was 38.3%. The laryngeal preservation rate was very high (96.2%). The combined laryngeal preservation and 5-year survival rate was 36.4%. Videofluoroscopic examinations and videoendoscopy showed almost no changes in swallow function. Only six patients (21.4%) required a tracheotomy and five patients (17.9%) required a gastrostomy. Most of the patients were able to swallow after chemoradiation. The results of a questionnaire concerning voice and swallowing ability were mostly good. The capsaicin test showed no change before and after treatment.</p><p>Conclusion: We concluded that this therapy is safe and is as useful as other treatment modalities for long-term organ preservation and the maintenance of function.</p>

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