Prognostic factor of severe complications in patients with hypopharyngeal cancer with primary concurrent chemoradiotherapy

Background/Aim: Organ-preservation treatment for hypopharyngeal cancer has recently become a popular treatment option. However, the severe complications and poor quality of life after non-surgical treatment should be avoided. We accessed the laryngeal or pharyngeal dysfunction-related complications after concurrent chemoradiotherapy (CCRT) as the primary treat ment for hypopharyngeal cancer. Patients and Methods: Data concerning all patients treated for hypopharyngeal cancer with primary non-surgical treatment at the China Medical University Hospital from 2002 to 2012 were retrospectively reviewed. Results: A total of 161 patients were included with a median age of 56.6 years. The disease control rates (disease-free >12 months) and severe complication rates were correlated to the tumor (T) stage and nodal (N) stage. In the successful treatment group, the complication rate was related to the N stage. The overall pharyngeal dysfunction, laryngeal dysfunction and aspiration rates were 36%, 27% and 25%, respectively. For patients with T4a disease, hyoid bone invasion significantly increased the severe complication rate (p=0.0212). Conclusion: The treatment outcome was correlated to the T and N stage. A higher rate of laryngo-pharyngeal dysfunction occurred when treating hyoid bone invasion in T4a patients with primary nonsurgical treatment. In advanced stage, but still resectable hypopharyngeal tumors, the poorer quality of life due to nonfunction larynx was noted after treating with CCRT.