16521 Background: To estimate the toxicity/efficacy of concurrent chemoradiation therapy (CCRT) and with different modalities for locally advanced hypopharyngeal carcinoma post ileocolic free flap reconstruction (ICFR). Methods: Between April 2003 and December 2006, 15 patients had enrolled and a total of 13 patients were treated for locally advanced hypopharyeal cancer after resection and ICFR. The majority in group was stage IVa and all were squamous cell histology. Five were treated with intensity modulated radiation therapy (IMRT)/chemotherapy (CT) and 8 were treated with the conventional radiotherapy (CRT)/CT, both to a median dose of 64.8 Gy. Two to three cycles of CT given concurrent with RT every 3 or 4 weeks of cisplatin, 15 mg/m2 i.v., D1–5, plus 5-FU, 750 mg/m2 continue infusion, D1–5. Two same regiment of CT had applied monthly after CCRT one month latter for all. Results: The mean survival was 33 months (range, 6–42 months). Two-year actuarial overall survival (OS), disease-free (DFS), locoregional progression-free (LRPF) and distant- metastases-free (DMF) rates of all were 74%, 67%, 83%, 83%, respectively. Comparing the IMRT and CRT group, two-year OS, DFS, LRP and DM rates were 67% vs. 62%, 75% vs. 63%, 75% vs. 87%, 100% vs. 75%, respectively. Except OS rate (p = 0.04), others were not statistically significant. In IMRT group, one left side lower neck failure was noted. In CRT group, one over flap and the other over level III of neck recurrent was noted. Speech ability above 70% in IMRT vs. CRT group were 4/5 (80%) vs. 4/8 (50%). Swallowing with solid diet in IMRT vs. CRT group were 3/5 (60%) vs.3/8 (37.5%). Grade III of dermatitis and mucositis for IMRT vs. CRT group were 40% vs. 100% and 20% vs. 87.5%. The median duration of post surgery to start CCRT and of CCRT were 33 days and 54 days. The interval from post-operation to start CCRT and of CCRT longer than median time would influence LRPF rate (p = 0.05). Conclusions: For locally advanced hypopharyngeal carcinoma post ICFR, IMRT results in lower toxicity, better speech, swallowing ability and superior treatment outcomes when compared with the CRT group. Prolong starting CCRT and extend CCRT time influence LRPF rate. No significant financial relationships to disclose.
Long term results of postoperative Intensity-Modulated Radiation Therapy (IMRT) in the treatment of Squamous Cell Carcinoma (SCC) located in the oropharynx or oral cavity
