This protocol addresses hypopharyngeal squamous cell carcinoma presenting at locally advanced stages, defined by specific tumour and nodal staging combinations without distant metastasis.

Clinical Scenario

Hypopharyngeal squamous cell carcinoma with either tumour stage cT1–T2 and nodal involvement cN1–N3 cM0, or tumour stage cT3 with any nodal stage cN0–N3 cM0. These staging categories define the patient population for which this structured regimen applies.

Treatment Approach

The standard approach involves concomitant chemoradiotherapy directed at both the primary tumour and regional nodes. Surgical options are also part of the framework, and distinct pathways exist for patients where laryngectomy becomes clinically necessary, as well as for patients in whom induction chemotherapy is pursued. Alternatives are defined for patients unable to receive the standard chemotherapy backbone. The complete decision algorithm — including fitness-adapted alternatives, induction sequencing, and post-treatment pathways — is available in the full protocol.

Treatment goal: Complete or partial tumour response after induction chemotherapy, where that pathway is selected.

References

DOI: 10.1016/j.annonc.2020.07.011

cT1−2 cN1−3 cM0, cT3 cN0−3 cM0
Concomitant CRT (T and N) [IV,A]
Surgery (T and N) followed by RT or CRT if indicated [IV, A]
If laryngectomy necessary, concomitant CRT (T and N) or induction ChT followed by (i) RT (T and N) in case of complete or partial response after induction or (ii) surgery (T and N) in case of stable or progressive disease after induction [I, A]
In patients unfit for cisplatin, carboplatin combined with 5-FU or cetuximab concomitant to RT as well as hyperfractionated or accelerated RT without ChT are treatment alternatives [II, A]

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Treatment of Hypopharyngeal Squamous Cell Carcinoma — cT1–T2 cN1–N3 or cT3 cN0–N3 cM0

Clinical Scenario

Treatment Approach

References