Radiotherapy with or without chemotherapy for T2N0 hypopharyngeal cancer: an analysis of the head and neck cancer registry of Japan.

PURPOSE: This retrospective study compared the outcomes of radiotherapy (RT) and chemoradiotherapy (CRT) in patients with T2N0 hypopharyngeal cancer.

METHODS

We analyzed patients with T2N0 hypopharyngeal squamous cell carcinoma treated with RT or CRT between 2011 and 2016 using data from the Head and Neck Cancer Registry of Japan.

RESULTS

Among 53,512 patients, 457 with T2N0 disease received RT (n = 165) or CRT (n = 292; median follow-up, 41.8 months; median age, 70 years). Tumor sites included the pyriform sinus (72.9%), postcricoid region (12.3%), posterior wall (11.8%), and unknown (3.1%). The groups differed in terms of age and alcohol use. Before weighing, CRT was associated with longer PFS and a lower cumulative incidence of locoregional recurrence compared with RT. However, in the IPTW-adjusted analysis, CRT did not significantly improve OS (hazard ratio [HR], 0.98; 95% confidence interval [CI], 0.59-1.62) or PFS (HR, 0.79; 95% CI, 0.53-1.16) compared with RT. PFS was associated with alcohol/smoking history, performance status, and primary site of the tumor.

CONCLUSION

In T2N0 hypopharyngeal cancer, CRT reduced the locoregional recurrence compared to RT. However, CRT did not confer a significant OS or PFS advantage over RT after adjustment for baseline imbalances. RT alone may, therefore, be a reasonable definitive treatment option for selected patients.