La radioterapia esclusiva dei carcinomi del seno piriforme. Analisi retrospettiva di 90 casi.

In the present study 90 patients affected with pyriform sinus carcinomas are analyzed. They underwent irradiation alone from 1970 to 1986. All cases were staged according to TNM criteria (UICC 1982): 7 were T1, 16 T2, 40 T3, 27 T4, 36 N0, 18 N1, 3 N2, 33 N3. Radiotherapy was performed with 60Co. In all cases doses of 60-70 Gy were delivered to T and N1 and doses of 45-50 Gy to N0. Locoregional control obtained in 35 patients (38.9%): 6/7 T1 (85.7%), 9/16 T2 (56.2%), 15/40 T3 (37.5%), 5/27 T4 (18.5%) and 20/36 N0, 8/18 N1, 1/3 N2, 6/33 N3. The overall and NED 3-year survival rates are 23.3% (21/90) and 20.0% (18/90), respectively; at 5 and 10 years all patients alive are NED, with survival rates of 12.2% (11/90) and 9.8% (5/51) respectively. Locoregional failures were observed in 12/35 cases (34.3%); 91% of them occurred within the first two years of follow up (mean: 10 months). Distant metastases appeared in 26/90 patients (28.9%) and secondary tumors occurred in 10/90 cases (11.1%). Our experience confirms radiotherapy to be an effective alternative treatment to surgery in the early stages (I-II) of pyriform sinus carcinomas, but no more than only a palliative treatment in stage III-IV cancers.