SURGERY AND POSTOPERATIVE RADIOTHERAPY AND RADIOTHERAPY ALONE IN T3-T4 CANCERS OF THE PYRIFORM SINUS - TREATMENT RESULTS AND PATTERNS OF FAILURE

Fifty-four patients with T3-T4 squamous cell carcinomas of the pyrifor m sinus were treated between 1976 and 1990. Surgery with postoperative radiotherapy (n = 32) was the treatment of choice. Radical radiothera py was used in patients with contraindications for surgery or with ino perable tumors and in patients who refused surgery. The local control rate was significantly higher in the combined treatment group (31/32; 97%) than in the group treated with radical radiotherapy (14/22; 64%) which consisted of more advanced cases. In patients who received radic al radiotherapy, the highest local control rates were recorded with do ses of 70 Gy and above and with the use of 2 fractions per day. There was no significant difference in regional control and survival rates b etween the treatment groups. New approaches are indicated to improve t he prognosis of hypopharyngeal cancer.