Radiation and low dose adriamycin for the treatment of carcinoma of the hypopharynx.

Purpose: To evaluate the utility of adriamycin in radiation therapy for hypopharyngeal cancer. Patients and Methods: Forty-five patients with hypopharyngeal carcinoma without distant metastasis were treated. Adriamycin was administered iv and weekly (15 mg iv/ once a week, median 64 mg) concurrently with radiation therapy to 38 patients, 76 % (34 out of 45) of whom were in an advanced stage (III or IV). Results: Overall survival, cause specific survival and local control rates at 5 years were respectively, 49%, 66% and 69% and better than results obtained in the 1970's. Radiation therapy achieved an 84% (38 out of 45) response rate at 40 Gy, Treatment without voice function loss was attained for 16 patients, consisting of 15 local CR (all T1 and 12 out of 26 T2 tumors) by radical radiation therapy and one posterior wall resection for a T2 tumor. Overall and cause specific survival rates were 57% and 91% at 5 years. Twenty patients who underwent further surgery showed 69% overall and 74% cause specific sunival rates. The remaining nine patients, who lost local control, died within 16 months. In 18 patients with T2 cancer originating from the pyriform sinus, 69 % local control was obtained for patients using adriamycin compared with 20% for patients without adriamycin (p=0.17). No severe side effect from the addition of adriamycin has been found so far. Conclusions: Radiation therapy using low dose adriamycin with or without follow-up surgery is safe and has potential to be a good option.