Larynx preservation protocols: long-term functional outcomes in good responders to induction chemotherapy for pyriform sinus carcinoma

ORL J Otorhinolaryngol Relat Spec. 2014;76(3):165-70. doi: 10.1159/000365394. Epub 2014 Jul 29.


Background/aims: Larynx preservation for laryngopharyngeal carcinomas aims to avoid the mutilation of a total laryngectomy without compromising survival or functionality. The aim of the present study on pyriform sinus squamous cell carcinoma (SCC) is to evaluate the long-term functional outcomes of larynx preservation in good responders to induction chemotherapy (ICT).

Methods: The study was carried out in a tertiary referral cancer center in France. The subjects were good responders to ICT for pyriform sinus SCC, subsequently treated with adjuvant radiation therapy (RT) - with or without concomitant chemotherapy - between 1999 and 2008. Only patients without recurrence at 3 years were included. The evaluated pharyngolaryngeal functions were airway patency, oral communication and oral feeding, based on a self-administered questionnaire and the patients' medical records.

Results: Twenty-eight patients were retained. Two (7%) patients needed a tracheotomy during or after the treatment and 2 (7%) had total laryngectomy for a late local recurrence. At least 3 years after the end of treatment, all patients were exclusively fed by mouth. All the evaluated patients judged their voice performance as 'adequate for everyday oral communication'.

Conclusions: In the long run, patients with pyriform sinus SCC who are candidates for larynx preservation and respond favorably to ICT present a satisfactory functional outcome when treated with adjuvant RT.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / physiopathology*
  • Chemoradiotherapy, Adjuvant
  • Combined Modality Therapy
  • Deglutition
  • Female
  • France
  • Humans
  • Hypopharyngeal Neoplasms / drug therapy
  • Hypopharyngeal Neoplasms / physiopathology*
  • Induction Chemotherapy / methods*
  • Laryngectomy
  • Larynx / physiopathology*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pyriform Sinus / drug effects
  • Pyriform Sinus / physiopathology*
  • Treatment Outcome
  • Voice