SURVIVAL AFTER CHEMOTHERAPY WITH CISPLATIN AND INFUSION OF BLEOMYCIN PRIOR TO LOCAL-REGIONAL TREATMENT IN PYRIFORM SINUS CANCER

Aims and background: The purpose of the study was to retrospectively c ompare different approaches including neoadjuvant chemotherapy. Method s: Ninety-six consecutive patients with pyriform sinus squamous cell c arcinoma with no distant metastases were entered, The first 48 patient s were treated with surgery plus postoperative radiation therapy (50-6 0 Gy) over cervical lymphatics. The next 48 patients were treated by i nduction chemotherapy with two courses of cisplatin, 120 mg/m(2) i.v. day one, plus bleomycin, 20 mg/m(2)/day for 5 consecutive days in 24-h r i.v. perfusion followed by definitive surgery and postoperative radi ation therapy as in the first therapeutic group. Results: Definitive s urgery was performed in 38 control vs 39 neoadjuvant patients, Complet e response was observed in 9 (18.7%) and partial response in 32 (66.7% ) of 48 chemotherapy-treated patients. Partial plus complete response was seen in 41 (85.4%) of the 48 patients. Comparison between controls versus chemotherapy-treated groups showed persistence of the disease in 10 vs 9 patients; local-regional relapses in 21 versus 14 patients; and distant metastases in 4 vs 2 patients. Median survival was 12 vs 40 months. Survival curves were statistically better in neoadjuvants t han in controls (P<0.025). Conclusions: Multidisciplinary therapy slig htly decreases the rate of local-regional relapses and distant metasta ses and should Improve survival in this set of pyriform sinus cancer p atients.