Hypopharyngeal cancer
ICD-10 C13 · ICD-11 2B6D

Hypopharyngeal Squamous Cell Carcinoma: What to Do When Induction Chemotherapy Does Not Achieve Tumour Response

Clinical Scenario

This protocol applies to locally advanced hypopharyngeal squamous cell carcinoma: either tumour stage cT1–T2 with nodal stage cN1–N3 cM0, or tumour stage cT3 across any nodal stage (cN0–N3 cM0). These patients are being managed under a larynx-preservation strategy that incorporates induction chemotherapy.

Why This Protocol Is Needed: Prior Treatment Did Not Meet Its Goal

The preceding treatment line used induction chemotherapy, with the clinical target of achieving a complete or partial tumour response — the threshold required to proceed to definitive radiotherapy and preserve the larynx. When that response is not reached and disease remains stable or progresses after induction, a different path is required. This protocol specifies what that path is.

Approach in This Setting

For patients whose disease does not respond to induction chemotherapy, the protocol directs management toward a surgical approach. The full regimen details — including precise indications, scope, and sequencing — are set out in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2020.07.011

cT1−2 cN1−3 cM0, cT3 cN0−3 cM0

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]

View source ↗