Preserving Laryngo‐Esophageal Function in Patients With Hypopharyngeal Cancer Treated With Radiotherapy: Predictive Factors and Long‐Term Outcomes

Abstract

ABSTRACT Background Functional outcomes after hypopharyngeal cancer (HPC) treatment have a significant effect on patients' quality of life and prognosis. This study aimed to identify the predictive factors associated with laryngo‐esophageal dysfunction in patients with HPC who received definitive radiotherapy. Methods Patients with HPC treated with definitive intensity‐modulated radiotherapy between 2007 and 2019 at our institution were retrospectively evaluated. Laryngo‐esophageal dysfunction‐free survival (LDFS) events were defined as local recurrence, laryngo‐esophageal dysfunction (defined as tracheostomy or feeding tube dependence), or death from any cause. Results The median follow‐up period was 61 months for the 80 patients included in the study. The 5‐year LDFS rate was 47%. A clinical T4 stage and lower pretreatment prognostic nutritional index (PNI) were independently associated with a lower LDFS. Conclusion A clinical T4 stage and lower pretreatment PNI were identified as predictors of a lower LDFS after definitive radiotherapy for HPC.

Keywords

• hypopharyngeal cancer
• intensity‐modulated radiotherapy
• laryngo‐esophageal dysfunction‐free survival
• predictive factors
• prognostic nutritional index