Hypopharynx Treatment Algorithm

Question 1

What is the treatment algorithm for T1-2 hypopharynx cancer?

Answer 1

Partial pharyngectomy or definitive XRT.

Add concurrent chemotherapy if bulky T2.

Question 2

What is the treatment algorithm for T3 and/or N+ hypopharynx cancer?

Answer 2

Good glottis function (eg. no dysphagia or other sx): Induction chemotherapy –> concurrent CRT or surgery depending on response to concurrent CRT

Poor glottis function (eg. dysphagia and other sx): Consider total laryngectomy or partial pharyngectomy

Question 3

What is the treatment algorithm for T4 hypopharynx cancer?

Answer 3

Total laryngectomy with thyroidectomy/partial pharyngoesophagectomy –> post-op XRT or chemoRT + margin or + ENE