Abstract
Purpose : To identify the spatial patterns of regional lymph node failure of locally advanced hypopharynx squamous cell carcinoma (SCC) after first-line treatment with surgery and/or intensity-modulated radiotherapy (IMRT).
Methods : We retrospectively analyzed 123 patients of the hypopharynx SCC consecutively treated with radical surgical resection and/or IMRT.
Results : Median PFS were 13 months (95% CI 6.4-19.6 months), and 11 months (95% CI 9.1-12.9 months) for patients receiving surgery and IMRT, respectively. The cervical lymph node failure was accounted for 32.5% of patients, with involved ipsilateral neck level II in 22 patients (55.0%), III in 12 patients (30.0%), IV in 2 patients (5%), VIb and VII both in 6 patients (5.0%), furthermore, involved contralateral neck level II in 7 patients (17.5%), III in 3 patients (7.5%). The commonly failure levels were the II (15.2%), III (8.7%), VIb (8.7%), and VII (10.9%) for surgery. The lymph node recurrence and persistent disease at levels II (24.7%) and III (13.0%) remained the major cause of failure following curative intent of IMRT.
Conclusions: Whatever the treatment modality, levels II and III were most commonly failure regions. Because of high rate of node failure of level VIb and VII for patients receiving surgery, post-operative radiation should included of these territories in locally advanced hypopharynx SCC.
Additional induction chemotherapy to concurrent chemotherapy and intensity-modulated radiotherapy with or without nimotuzumab in first-line treatment for locoregionally advanced nasopharyngeal carcinoma: a propensity score matched analysis