Concurrent Chemoradiation is a Better Alternative than Radiotherapy alone in the Treatment of Inoperable Carcinoma Pyriform Fossa-A Multi Centre Clinical Experience in Bangladesh

Author(s): Bhuiyan MZR, Hasan T, Rasheed MO, Sharmin S, Razib SFA

Background: The present study was aimed at describing a multicentre clinical experience in the treatment of Inoperable carcinoma pyrifom fossa. Carcinoma pyriform fossa is the most frequent cancer arising from the hypopharynx, is rarely diagnosed in its early stage and still a leading cause of mortality and morbidity in developing countries. Despite improvement in overall survival for pyriform fossa cancer, the locally advanced cancer remains essentially incurable.

Methods: This prospective observational study was carried out to compare the effects of concurrent chemoradiation and radiotherapy alone in locally advanced carninoma pyriform fossa cancer. The main objectives of this study are to assess the response and early toxicities in both concurrent chemoradiation and radiotherapy alone.

Results: A total number of 90 patients, 45 in each arm having advanced pyriform fossa cancer were included in the study. Highest percentage of the patients was habituated with smoking, betal nut chewing and tobacco leaf user. The most common presenting symptoms were cervical lymphadenopathy, sore throat and hoarseness of voice. Overall response of patients treated with concurrent chemoradiation was better than in comparison to only radiotherapy. As only a new treatment of locally advanced carcinoma of pyriform fossa concurrent chemoradiation (group-A) represents better symptom improvement, more toxicities and better tumor responses than radiotherapy alone (group-B) regimen.

Conclusion: In the treatment of locally advanced carcinoma pyriform fossa, concurrent chemoradiation with paclitaxel (40mg/m2I/V) weekly, represents better symptom improvement, tumor responses with manageable toxicities than radiotherapy alone.

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