A retrospective study about the impact of different treatments on prognosis of patients with locally advanced hypopharyngeal squamous cell carcinoma

Abstract Objectives: The treatment approaches for patients with locally advanced hypopharyngeal squamous cell carcinoma (LA-HSCC) still lack standardized guideline. Therefore, this study aims to clarify the most beneficial non-surgical treatment options for patients with HSCC. Methods: A total of 136 patients with stage III/IV LA-HSCC were enrolled. The treatment groups included concurrent chemoradiotherapy (CCRT)(n=42), induction chemotherapy+CCRT (Indu+CCRT)(n=33), and induction chemotherapy+radiotherapy (Indu+RT)(n=61). We performed a retrospective analysis to evaluate the survival of patients and examine the occurrence of acute adverse effects (AEs) using SPSS software. Results: The overall survival (OS) rates were 37.9%, 34.4%, and 15.7% in CCRT, Indu+CCRT, and Indu+RT groups (P=0.043), while the 5-year PFS rates were 35.6%, 42.3%, and 19.2% respectively (P=0.045). Subgroup analysis (age≥61) showed that OS have no difference between CCRT and Indu+CCRT groups, but higher than Indu+RT group. Subgroup analysis of PFS revealed that Indu+CCRT group had better outcomes for patients with N2-3 stage or stage IV (P=0.011, P=0.025). About 97.0% patients in Indu+CCRT group occurred adverse events (AEs) and 48.5% occurred stage III-IV AEs, which were both highest among 3 groups. Conclusion: The data indicate that there is no significant difference in survival benefits between CCRT and Indu+CCRT for LA-HSCC patients, but both higher than Indu+RT. However, CCRT was recommend to older patients (≥61 years), and Indu+CCRT was recommend to patients with stage IV disease or advanced N stage.