Skip to main content
SpringerLink
Log in
Book cover

Carcinoma of the Larynx and Hypopharynx pp 163–177Cite as

Larynx Preservation in Hypopharyngeal Carcinomas

  • Chapter
  • First Online:

  • 662 Accesses

Abstract

The hypopharynx consists of three parts, pyriform sinus, posterior pharyngeal wall, and post-cricoid region covered by mucosal lining, which gives rise to carcinoma mainly of squamous cell type. Hypopharyngeal cancers (HPC), more so in advanced stages, are characterized by aggressive disease and dismal treatment outcomes. The main goal of treatment in carcinoma hypopharynx is not only to achieve cure but also to ensure adequate preservation of voice and eating capacity. In order to achieve the goal, there is a paradigm shift in the treatment approaches. The advancements and refinements in nonsurgical therapies have been brought in a lesser reliance on surgical management of hypopharyngeal cancers. In the past two decades, guidelines on larynx preservation have been published for advanced laryngopharyngeal cancers. However, given the entirely different natural history and poor prognosis for hypopharyngeal cancers as compared to laryngeal cancer, the issue of larynx preservation needs to be separately addressed for these rare and aggressive tumors. In the present chapter, we discuss pertinent aspects of larynx preservation by nonsurgical approaches for the locally advanced hypopharyngeal cancers. It is imperative that organ preservation outcomes should be correlated with morbidity and potential factors that can reduce chemoradiotherapy-related late morbidity and aid better organ functions.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Gupta T, Chopra S, Agarwal JP, Laskar SG, D’cruz AK, Shrivastava SK, Dinshaw KA. Squamous cell carcinoma of the hypopharynx: single-institution outcome analysis of a large cohort of patients treated with primary non-surgical approaches. Acta Oncol. 2009;48:541–8.

    Article  Google Scholar 

  2. Petersen JF, Timmermans AJ, van Dijk BAC, et al. Trends in treatment, incidence and survival of hypopharynx cancer: a 20-year population-based study in the Netherlands. Eur Arch Otorhinolaryngol. 2018;275:181–9.

    Article  Google Scholar 

  3. Krstevska V. Hypopharyngeal Cancer. In: Agulnik M, editor. Head and Neck Cancer. London: InTech; 2012. ISBN: 978-953-51-0236-6. Available from: http://www.intechopen.com/books/head-and-neckcancer/hypopharyngeal-cancer.

    Google Scholar 

  4. Pracy P, Loughran S, Good J, Parmar S, Goranova R. Hypopharyngeal cancer: United Kingdom National multidisciplinary guidelines. J Laryngol Otol. 2016;130(S2):S104–10.

    Article  CAS  Google Scholar 

  5. Hall SF, Groome PA, Irish J, O’Sullivan B. Radiotherapy or surgery for head and neck squamous cell cancer: establishing the baseline for hypopharyngeal carcinoma? Cancer. 2009;115:5711–22.

    Article  Google Scholar 

  6. Takes RP, Strojan P, Silver CE, Bradley PJ, Haigentz M Jr, Wolf GT, Shaha AR, Hartl DM, Olofsson J, Langendijk JA, Rinaldo A, Ferlito A. International Head and Neck Scientific Group. Current trends in initial management of hypopharyngeal cancer: the declining use of open surgery. Head Neck. 2012;34:270–81.

    Article  Google Scholar 

  7. Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. 1996;88:890–9.

    Article  CAS  Google Scholar 

  8. Zelefsky MJ, Kraus DH, Pfister DG, Raben A, Shah JP, Strong EW, Spiro RH, Bosl GJ, Harrison LB. Combined chemotherapy and radiotherapy versus surgery and postoperative radiotherapy for advanced hypopharyngeal cancer. Head Neck. 1996;18:405–11.

    Article  CAS  Google Scholar 

  9. Department of Veterans Affairs Laryngeal Cancer Study Group, Wolf GT, Fisher SG, Hong WK, Hillman R, Spaulding M, Laramore GE, Endicott JW, McClatchey K, Henderson WG. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med. 1991;324:1685–90.

    Article  Google Scholar 

  10. Lefebvre JL, Andry G, Chevalier D, et al. Laryngeal preservation with induction chemotherapy for hypopharyngeal squamous cell carcinoma: 10-year results of EORTC trial 24891. Ann Oncol. 2012;23:2708–14.

    Article  Google Scholar 

  11. Pignon JP, Bourhis J, Domenge C, Designé L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet. 2000;355(9208):949–55.

    Article  CAS  Google Scholar 

  12. Adelstein DJ, Li Y, Adams GL, Wagner H Jr, Kish JA, Ensley JF, Schuller DE, Forastiere AA. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 2003;21:92–8.

    Article  Google Scholar 

  13. Pignon JP, LeMaitre A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomized trials and 17,346 patients. Radiother Oncol. 2009;92:4–14.

    Article  Google Scholar 

  14. Corvò R. Evidence-based radiation oncology in head and neck squamous cell carcinoma. Radiother Oncol. 2007;85:156–70.

    Article  Google Scholar 

  15. Hitt R, López-Pousa A, Martínez-Trufero J, et al. Phase III study comparing cisplatin plus fluorouracil to paclitaxel, cisplatin, and fluorouracil induction chemotherapy followed by chemo-radiotherapy in locally advanced head and neck cancer. J Clin Oncol. 2005;23:8636–45.

    Article  Google Scholar 

  16. Janoray G, Pointreau Y, Garaud P, Chapet S, Alfonsi M, Sire C, Jadaud E, Calais G. Long-term results of a multicenter randomized phase III trial of induction chemotherapy with cisplatin, 5-fluorouracil, ± docetaxel for larynx preservation. J Natl Cancer Inst. 2015;108(4):djv368. https://doi.org/10.1093/jnci/djv368. 1 April 2016.

    Article  CAS  PubMed  Google Scholar 

  17. Lorch JH, Goloubeva O, Haddad RI, Cullen K, Sarlis N, Tishler R, Tan M, Fasciano J, Sammartino DE, Posner MR, TAX 324 Study Group. Induction chemotherapy with cisplatin and fluorouracil alone or in combination with docetaxel in locally advanced squamous-cell cancer of the head and neck: long-term results of the TAX 324 randomised phase 3 trial. Lancet Oncol. 2011;12:153–9. https://doi.org/10.1016/S1470-2045(10)70279-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Cohen EE, Karrison TG, Kocherginsky M, Mueller J, et al. Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer. J Clin Oncol. 2014;32:2735–43.

    Article  CAS  Google Scholar 

  19. Bozec A, Benezery K, Ettaiche M, Chamorey E, Vandersteen C, et al. Induction chemotherapy-based larynx preservation program for locally advanced hypopharyngeal cancer: oncologic and functional outcomes and prognostic factors. Eur Arch Otorhinolaryngol. 2016;273:3299–306.

    Article  Google Scholar 

  20. Bonner JA, Harari PM, Giralt J, Azarnia N, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med. 2006;354:567–78.

    Article  CAS  Google Scholar 

  21. Lefebvre JL, Pointreau Y, Rolland F, Alfonsi M, Baudoux A, et al. Induction chemotherapy followed by either chemoradiotherapy or bioradiotherapy for larynx preservation: the TREMPLIN randomized phase II study. J Clin Oncol. 2013;31:853–9.

    Article  CAS  Google Scholar 

  22. Owen RD. The problem of hypopharyngeal carcinoma. Proc R Soc Med. 1950;43:157–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Bataini P, Brugere J, Bernier J, Jaulerry CH, Picot C, Ghossein NA. Results of radical radiotherapeutic treatment of carcinoma of the pyriform sinus: experience of the Institut Curie. Int J Radiat Oncol Biol Phys. 1982;8:1277–86.

    Article  CAS  Google Scholar 

  24. Ahmad K, Fayos JV. Role of radiation therapy in carcinoma of the hypopharynx. Acta Radiol Oncol. 1984;23:21–6.

    Article  CAS  Google Scholar 

  25. Huang WY, Jen YM, Chen CM, Su YF, Lin CS, Lin YS, Chang YN, Chao HL, Lin KT, Chang LP. Intensity modulated radiotherapy with concurrent chemotherapy for larynx preservation of advanced resectable hypopharyngeal cancer. Radiat Oncol. 2010;15(5):37.

    Article  Google Scholar 

  26. Teoh M, Clark CH, Wood K, Whitaker S, Nisbet A. Volumetric modulated arc therapy: a review of current literature and clinical use in practice. Br J Radiol. 2011;84:967–96.

    Article  CAS  Google Scholar 

  27. Moncharmont C, Vallard A, Guy JB, Prades JM, Rancoule C, Magné N. Real-life efficacy of volumetric modulated arc therapy in head and neck squamous cell carcinoma. Eur Ann Otorhinolaryngol Head Neck Dis. 2017;134:165–9.

    Article  CAS  Google Scholar 

  28. Lacas B, Bourhis J, Overgaard J, Zhang Q, Grégoire V, Nankivell M, MARCH Collaborative Group, et al. Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis. Lancet Oncol. 2017;18:1221–37.

    Article  Google Scholar 

  29. Overgaard J, Mohanti BK, Begum N, Ali R, Agarwal JP, Kuddu M, Bhasker S, Tatsuzaki H, Grau C. Five versus six fractions of radiotherapy per week for squamous-cell carcinoma of the head and neck (IAEA-ACC study): a randomised, multicentre trial. Lancet Oncol. 2010;11:553–60.

    Article  Google Scholar 

  30. Lefebvre JL. Candidates for larynx preservation: the next step? Oncologist. 2010;15(Suppl. 3):30–2.

    Article  Google Scholar 

  31. Lagha A, Chraiet N, Labidi S, Rifi H, Ayadi M, et al. Larynx preservation: what is the best non-surgical strategy? Crit Rev Oncol Hematol. 2013;88:447–58.

    Article  Google Scholar 

  32. Ang KK. Larynx preservation clinical trial design: summary of key recommendations of a consensus panel. Oncologist. 2010;15(Suppl. 3):25–9.

    Article  Google Scholar 

  33. Caudell JJ, Carroll WR, Spencer SA, Bonner JA. Examination of laryngoesophageal dysfunction-free survival as an endpoint in nonsurgical treatment of squamous cell carcinomas of the larynx and hypopharynx. Cancer. 2011;117:4447–51.

    Article  Google Scholar 

  34. Sherman EJ, Fisher SG, Kraus DH, Zelefsky MJ, et al. TALK score: development and validation of a prognostic model for predicting larynx preservation outcome. Laryngoscope. 2012;122:1043–50.

    Article  Google Scholar 

  35. Rosenthal DI, Mohamed AS, Weber RS, Garden AS, et al. Long-term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: a 3-decade survey. Cancer. 2015;121:1608–19.

    Article  Google Scholar 

  36. Chen LY, Huang CC, Tsou YA, Bau DT, Tsai MH. Prognostic factor of severe complications in patients with hypopharyngeal cancer with primary concurrent chemoradiotherapy. Anticancer Res. 2015;35:1735–41.

    PubMed  Google Scholar 

  37. Bradley PT, Bradley PJ. Treatment of hypopharyngeal carcinoma with primary chemoradiotherapy: functional morbidity. Curr Opin Otolaryngol Head Neck Surg. 2012;20:89–96.

    Article  Google Scholar 

  38. Al-Mamgani A, Mehilal R, van Rooij PH, Tans L, Sewnaik A, Levendag PC. Toxicity, quality of life, and functional outcomes of 176 hypopharyngeal cancer patients treated by (chemo)radiation: the impact of treatment modality and radiation technique. Laryngoscope. 2012;122:1789–95.

    Article  Google Scholar 

  39. Bossola M. Nutritional interventions in head and neck cancer patients undergoing chemoradiotherapy: a narrative review. Nutrients. 2015;7:265–76.

    Article  Google Scholar 

  40. Eisbruch A, Schwartz M, Rasch C, Vineberg K, et al. Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT? Int J Radiat Oncol Biol Phys. 2004;60:1425–39.

    Article  Google Scholar 

  41. Newman JR, Connolly TM, Illing EA, Kilgore ML, Locher JL, Carroll WR. Survival trends in hypopharyngeal cancer: a population-based review. Laryngoscope. 2015;125:624–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, BLK Super Specialty Hospital, New Delhi, India

    Shelley Hukku & Shikha Halder

  2. Department of Radiation Oncology, Manipal Hospital, New Delhi, India

    Bidhu K. Mohanti

Authors
  1. Shelley Hukku
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shikha Halder
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bidhu K. Mohanti
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. All India Institute of Medical Sciences, New Delhi, India

    Sudhir Bahadur

  2. All India Institute of Medical Sciences, New Delhi, India

    Alok Thakar

  3. Department of Radiation Oncology, Manipal Hospital, New Delhi, India

    Bidhu K. Mohanti

Rights and permissions

Reprints and permissions

Copyright information

© 2019 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hukku, S., Halder, S., Mohanti, B.K. (2019). Larynx Preservation in Hypopharyngeal Carcinomas. In: Bahadur, S., Thakar, A., Mohanti, B. (eds) Carcinoma of the Larynx and Hypopharynx . Springer, Singapore. https://doi.org/10.1007/978-981-13-3110-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-3110-7_12

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-3109-1

  • Online ISBN: 978-981-13-3110-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation