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학술저널
저자정보
Kim, Nalee (Department of Radiation Oncology, Yonsei University College of Medicine) Lee, Jeongshim (Department of Radiation Oncology, Yonsei University College of Medicine) Kim, Kyung Hwan (Department of Radiation Oncology, Yonsei University College of Medicine) Park, Jong Won (Department of Radiation Oncology, Yonsei University College of Medicine) Lee, Chang Geol (Department of Radiation Oncology, Yonsei University College of Medicine) Keum, Ki Chang (Department of Radiation Oncology, Yonsei University College of Medicine)
저널정보
대한방사선종양학회 Radiation oncology journal : ROJ Radiation oncology journal : ROJ 제34권 제4호
발행연도
2016.1
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280 - 289 (10page)

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Purpose: Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Materials and Methods: Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. Results: At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). Conclusion: This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.

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