2018 Head & neck

Radiotherapy modality as a predictor of survival in hypopharyngeal cancer.

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Head & neck Vol. 40 (11) : 2441-2448 • Nov 2018

BACKGROUND: The impact of radiotherapy (RT) modality and dose on survival in hypopharyngeal cancer managed with definitive RT is unclear. METHODS: The National Cancer Database was queried for patients with hypopharyngeal squamous cell carcinoma (HPSCC) treated with definitive RT. Intensity-modulated radiotherapy (IMRT) was compared with other RT techniques. Clinicopathologic variables, RT modality, and dose impact on overall survival (OS) were assessed using log-rank test and Cox proportional hazard models. RESULTS: A total of 3928 patients with HPSCC were identified. Patients receiving IMRT (2098 patients) were more likely to be white, have higher income, have advanced classification, receive >/=66 Gy, and receive chemoradiotherapy compared with those receiving non-IMRT techniques (1830 patients). The 5-year OS was 41.9% (95% CI = 39.4%-44.4%) for the IMRT group and 36.8% for the non-IMRT group (95% CI = 34.3%-39.2%). After propensity score matching, IMRT had significantly better OS (P = .013). CONCLUSION: In HPSCC treated with definitive RT, IMRT may provide a significant survival benefit over non-IMRT modalities.

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