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There is no visible transitional zone between these two regions. The epithelium of the pharyngeal mucous membrane is squamous and continuous with the nasopharyngeal epithelial membrane. The hypopharyngeal walls are composed of four layers of tissue: mucosa, fibrous fascia, a muscular layer, and areolar coat.In this way, the hypopharynx is lateral to and behind the larynx. This creates a central aerodigestive passageway and two lateral fossae (i.e., the pyriform sinuses) ( Fig. The larynx indents the anterior wall of the hypopharynx to form a horseshoe-shaped hollow cavity.It communicates with the oropharynx via the esophageal inlet. It extends from the level of the hyoid bone, the base of the vallecula, and pharyngoepiglottic folds, to the esophageal inlet and cricopharyngeus at the plane of the lower border of the cricoid cartilage ( Fig. The hypopharynx or laryngopharynx is the most inferior portion of the pharynx.
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Multiple ipsilateral lymph nodes were delineated, including bulky level II nodes. (PMID 19449227)įIGURE 9-9. CTV1, CTV2, and CTV3 delineation in a patient with clinically T3N3M0 squamous cell carcinoma of the right pyriform sinus who received definitive IMRT with concurrent chemotherapy. At 2 years, laryngeal preservation was significantly higher in the concurrent chemoradiotherapy arm.
#El p cancer for cure rar 320 trial
(Acta Otolaryngol 2010) reported their phase III trial comparing induction chemotherapy with cisplatin and 5-fluorouracil followed by radiation to concurrent cisplatin and radiation in patients with T3M0 pyriform sinus cancer. Both chemotherapy groups showed improved laryngectomy-free survival as compared to radiation alone. (JCO 2012) reported the long-term results of RTOG 91-11 with 10.8 years median follow-up, concomitant cisplatin and radiotherapy had a significantly higher rate of locoregional control and larynx preservation than observed with induction chemotherapy with cisplatin and 5-fluorouracil followed by radiation. Hypopharynx and Larynx Cancer – Highlightsįorastiere et al. Practical Essentials of Intensity Modulated Radiation Therapy, 3 Ed.