Indian clinical practice consensus guidelines for the management of hypopharyngeal cancer: Update 2022

Abstract

In early hypopharyngeal cancer, definitive radiotherapy (RT) is the preferred modality of treatment. The surgical treatment options are transoral laser microsurgery with selective neck dissection or a partial laryngopharyngectomy plus neck dissection. In locally advanced disease, concurrent chemoradiotherapy (CTRT) is the treatment of choice. Neoadjuvant chemotherapy (NACT) is also a recommended treatment option followed by radical RT/CTRT or surgery followed by adjuvant RT/CTRT, depending on the response. Some patients with locally advanced disease may require total or near total laryngectomy/total or partial pharyngectomy with appropriate neck dissection. Adding targeted therapies like nimotuzumab to cisplatin-based CTRT in locally advanced head-and-neck squamous cell carcinoma improves progression-free survival, locoregional control, and disease-free survival without negatively impacting the quality of life.