Hypopharyngeal Squamous Cell Carcinoma cT4a: When Induction Chemotherapy Did Not Achieve Response

This protocol covers resectable advanced hypopharyngeal squamous cell carcinoma — tumour stage cT4a, node stage cN0–N3, metastasis stage cM0 — in patients whose disease remained stable or progressed after induction chemotherapy, meaning the prior response goal was not reached.

Clinical Scenario

Hypopharyngeal squamous cell carcinoma, cT4a cN0–N3 cM0. At this tumour stage, laryngeal cartilage invasion is characteristic, and advanced hypopharyngeal cancers presenting with such features or a non-functional larynx may require surgical consideration.

Prior Treatment Line — Goal Not Met

The previous treatment step included induction chemotherapy. The aim was to achieve a complete or partial tumour response, which would have guided subsequent management. When induction chemotherapy does not reach that response threshold — leaving disease stable or progressive — this protocol defines the next step.

Next Step (Partial Overview)

For patients with stable or progressive disease after induction chemotherapy, a surgical approach addressing both the primary tumour and regional nodes is part of the management framework. The complete sequencing, criteria, and full protocol details are available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2020.07.011

cT4a cN0−3 cM0

Advanced hypopharyngeal cancers may also be treated surgically, especially when there is laryngeal cartilage invasion (i.e. stage T4) or a non-functional larynx [III, A].

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]

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