[Therapy of hypopharyngeal cancer. Part II: Review of the literature for using chemotherapy within the scope of multimodality therapy].

Supplemental to the previous publication on the results of surgery and/or radiotherapy, the application of various cytostatic drugs--neoadjuvant, sequential, simultaneous, alternating or adjuvant--in addition to surgery and/or radiotherapy in the treatment of hypopharynx carcinomas is subjected to critical analysis. Exclusively for these carcinomas there are still no results of prospectively randomized studies, although this may reflect their relatively small incidence when compared with all head and neck tumors. Induction chemotherapy (before standard therapy) has been disappointing clinically, at least concerning hypopharynx carcinomas. To date, organ and function preservation with improved survival in these neoplasms has not been shown clearly, even for resectable tumors. Simultaneous radiochemotherapy is obviously superior to sequential chemotherapy and has demonstrated higher remission rates when compared to conventional radiotherapy, but the effectiveness of modified fractionizing patterns must be kept distinct from the effectiveness of simultaneous chemotherapy. Moreover, it must be defined whether the observed decline in the rate of distant metastases after adjuvant chemotherapy entails (statistically) significant higher survival rates. Only with the help of prospective randomized multicenter studies can the true benefits of chemotherapy be verified and specified in the treatment of hypopharynx carcinomas. The results of chemotherapy to date are critically reviewed and future concepts planned.