Multidisciplinary Management of Hypopharyngeal Carcinoma

Hamoir, Marc;Machiels, Jean-Pascal;Schmitz, Sandra;Grégoire, Vincent
(2016) Head and Neck Cancer : Multimodality Management — ISBN: [978-3-319-27599-4], p. 511-538, published

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Abstract
Despite advances in treatment modalities, the management of hypopharyngeal squamous cell carcinoma (SCC) remains diffi cult. Most patients have advanced locoregional disease at the time of diagnosis. Treatment selection favors laryngeal preservation approaches either surgically or non- surgically to improve the quality of life without compromising locoregional control and survival. For patients with early disease, conservation surgery and primary radiotherapy are equally effective therapeutic options. For patient with advanced locoregional disease, a conservative treatment combining chemotherapy and radiotherapy should be favored. Total laryngopharyngectomy (TLP) remains indicated in tumors not suitable for conservative nonsurgical approaches and for salvage. Despite a good locoregional control rate, most patients succumb to distant metastases, intercurrent diseases, or second primaries. Future developments should be connected with treatments with a better toxicity profi le than chemotherapy aimed to decrease the rate of late distant recurrences and the occurrence of second primaries. Targeted agents could be nicely incorporated into the standard regimen to either improve effi cacy and/or decrease treatment toxicity. Ongoing studies investigating the combination of targeted agent administration during or after induction chemotherapy or with concomitant chemoradiation regimens will help to better defi ne the respective role of chemotherapy and targeted agents in the multimodal treatment of this disease. In addition, efforts to identify predictive biomarkers that could help to better select the patients who will benefi t of a specifi c treatment modality are of crucial importance.
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Hamoir, M., Machiels, J.-P., Schmitz, S., & Grégoire, V. (2016). Multidisciplinary Management of Hypopharyngeal Carcinoma. In Jacques Bernier (ed.), Head and Neck Cancer : Multimodality Management (p. p. 511-538). Springer International Publishing Switzerland. https://doi.org/10.1007/978-3-319-27601-4_28