[Target volume including the nasopharynx for radiotherapy of hypopharyngeal squamous cell carcinoma: whether or not].

Background And Objective: There is controversy in whether the nasopharynx should be included in target volume for radiotherapy of hypopharyngeal squamous cell carcinoma. This study was to analyze the necessity of radiotherapy including the nasopharynx for patients with hypopharyngeal squamous cell carcinoma.

Methods: Clinical data of 196 patients with hypopharyngeal squamous cell carcinoma treated in Cancer Center of Sun Yat-sen University from May 1994 to August 2006 were analyzed. Of the 196 cases of hypopharyngeal carcinoma, three were at stage I, 26 at stage II, 38 at stage III, and 129 at stage IV. Ninety-four patients received radiotherapy, 49 received surgery and 53 received surgery combined with radiotherapy. The nasopharynx was included in target volume in 78 patients, but excluded in 69 patients. The prognosis of the two groups were compared.

Results: The 3-year and 5-year overall survival rates were 38.57% and 21.69%. The 5-year survival rates were 100% in stage I patients, 43.08% in stage II patients, 27.57% in stage III patients, and 13.99% in stage IV patients, and were 13.90% in surgery group, 10.60% in radiotherapy group, and 44.08% in combined therapy group. Between nasopharynx-included and nasopharynx-excluded groups, there was no significant difference in 5-year overall survival rate (24.44 % vs. 20.68%, kappa2=0.10,P=0.76),5-year progression-free survival rate (15.99% vs. 10.91%, kappa2=0.65, P=0.42), relapse rate and metastasis rate (kappa2=1.56, P=0.21). Relapse in cervical lymph nodes occurred in 39 patients; no relapse in the nasopharynx was observed.

Conclusions: Combined therapy is recommended for advanced hypopharyngeal squamous cell carcinoma. The target volume including the nasopharynx is not recommended. Controlling cervical lymph node metastasis may be helpful for prolonging survival.