Overview
Adenoid squamous cell carcinoma is a rare subtype of squamous cell carcinoma that can occur in the hypopharynx. The hypopharynx is the part of the throat located below the oropharynx and above the esophagus.Diagnosis
Management
Intensity-modulated radiotherapy is the gold standard treatment for hypopharyngeal cancers 2.
Early T1 and T2 tumors can be treated with exclusive radiotherapy or surgery followed by postoperative radiotherapy if there is a high risk of recurrence 2.
For locally advanced tumors requiring total pharyngolaryngectomy or with significant lymph node involvement, induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy are possible options 2.
T4 tumors should be treated with surgery 2.
Treatment of lymph nodes depends on the initial primary tumor treatment 2.
Curative radiotherapy doses range from 66 Gy in 30 fractions to 70 Gy in 35 fractions, with prophylactic doses ranging from 50 to 56 Gy 2. Doses over 2 Gy per fraction may be used when chemotherapy is not administered, considering potential laryngeal toxicity 2.Special Populations
Opium use is a significant risk factor for head and neck cancers, including those of the pharynx, with an approximately eightfold increased risk of laryngeal cancer 1.Key Recommendations
Intensity-modulated radiotherapy is the preferred treatment modality for hypopharyngeal cancers 2. (Evidence: Expert opinion)
Early-stage (T1-T2) hypopharyngeal cancers can be managed with either exclusive radiotherapy or surgery followed by postoperative radiotherapy for high-risk cases 2. (Evidence: Expert opinion)
Locally advanced hypopharyngeal cancers (T2-T3 with nodal involvement) may be treated with induction chemotherapy followed by radiotherapy or concurrent chemoradiotherapy 2. (Evidence: Expert opinion)
T4 hypopharyngeal cancers warrant surgical intervention 2. (Evidence: Expert opinion)
Opium use is a significant risk factor for head and neck cancers, including those of the pharynx 1. (Evidence: Moderate)References
1 Mohebbi E, Alimoradi Z, Rozek LS, Mohebbi A, Jafari E. Risk of head and neck cancer among opium users. Archives of oral biology 2024. link
2 Pointreau Y, Biau J, Delaby N, Thariat J, Lapeyre M. Radiotherapy for hypopharynx cancers. Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique 2022. link