By M. Agulnik

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For the small lesions of the pyriform sinuses, partial pharyngectomy or partial pharyngolaryngectomy should be considered. , 1978). Additionally, attention must be paid to the possible caudal, contralateral, and extralaryngeal extension, and soft tissue invasion. , 1987). In patients with T1 and T2 lesions of the lateral wall of the pyriform sinus, partial pharyngectomy through a lateral approach is indicated. Partial pharyngectomy through a transhyoid pharyngotomy, posterior pharyngectomy, or lateral pharyngotomy are conservation surgery procedures that allow the excision of T1 and small T2 lesions confined to the posterior wall of the hypopharynx.

The results of metaanalysis reported by Munro (Munro, 1995), and the results of meta-analysis of El-Sayed and Nelson (El-Sayed & Nelson, 1996) showed a statistically significant improvement in survival for chemotherapy given concurrently with radiotherapy. The largest metaanalysis performed by the Meta-Analysis of Chemotherapy on Head and Neck Cancer (MACH-NC) Collaborative Group and published by Pignon et al. , 2000) in 2000, evaluated individual patient data from 63 randomised trials excluding trials on nasopharyngeal carcinoma.

2000). , 2000). The renewed interest in induction chemotherapy arisen from data showing treatment failure due to the development of distant metastases in 1 of 5 patients with stage III-IV head and neck cancer treated with multimodality approaches including concurrent chemoradiotherapy (Bernier & Bentzen, 2003) led to the evaluation of the use of both induction chemotherapy and concurrent chemoradiotherapy in a sequential approach supposed to provide optimal benefit for this patients category.

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