Radiotherapy for hypopharyngeal carcinoma in Senegal: Experience of the main cancer care facility

Fatimatou Néné Sarr 1, *, Mouhamadou bachir Ba 1, Mouhamadou dioulde Diallo 2, Rachidou Hamadou 1, Awa sadikh Badiane 1,  El hadji aliou Baldé 3, Ndéye fatou kane Ba 1, Massamba Diène 1, Malick Ndiaye 4, Papa macoumba Gaye 1 and Mamadou moustapha Dieng 1

1 Radiotherapy department, Dalal Jamm Hospital, Dakar, Senegal
2 Otorhinolaryngology department, Ouakam Military hospital, Dakar, Senegal.
3 Radiotherapy department, Cheikhoul khadim Hospital, Dakar, Senegal.
4 Oto-Rhino-Laryngology Department of Fann Hospital, Cheikh Anta Diop University of Dakar, Dakar, Senegal
 
Research Article
World Journal of Advanced Research and Reviews, 2024, 23(03), 799–806
Article DOI: 10.30574/wjarr.2024.23.3.2345
 
Publication history: 
Received on 23 June 2024; revised on 09 August 2024; accepted on 12 August 2024
 
Abstract: 
Objectives: To describe the epidemiological, diagnostic, therapeutic, and prognostic factors associated with patients treated for hypopharyngeal carcinoma at the Radiotherapy Department of the National Hospital Center Dalal Jamm.
Patients and Methods: Data from 50 consecutive patients treated for hypopharyngeal carcinoma between 2018 and 2022 were retrospectively analyzed. All patients received three-dimensional conformal radiotherapy (3DCRT) with or without chemotherapy. Epidemiological and diagnostic data, treatment details, and therapeutic outcomes were collected in an Excel 2016 database created for the study. Statistical analyses were performed using SPSS version 20.0. Overall survival estimates were generated using the Kaplan-Meier method. Statistical significance was considered at p = 0.05. Uni- and multivariate analyses were conducted to identify prognostic factors associated with survival.
Results: The average age of the patients was 44 years (± 14.4 years), with a male-to-female ratio of 0.56. Sixteen percent of the patients were active smokers and 4% were alcohol consumers. The mean delay to the first consultation was 6 months, and dysphagia was the primary symptom (92%). The majority of patients (89.8%) were classified as stage IVa, and 10% had metastases at diagnosis. Treatment consisted of curative concurrent chemoradiotherapy (95.92%), preceded by induction chemotherapy in 58% of patients. A radiation dose of 70 Gy was utilized in 75% of cases. The 2-year overall survival rate was 25%. Multivariate analysis indicated that the presence of feeding gastrostomy (p=0.044), use of induction chemotherapy (p=0.012), and radiation dose less than 70 Gy (p=0.020) were associated with poorer survival.
Conclusion: Concurrent chemoradiotherapy using 3D conformal techniques improved management, although outcomes remain unsatisfactory. Prospective cohort studies are imperative to identify specific risk factors in our population. Additionally, timely access to appropriate treatment modalities could enhance prognosis.
 
Keywords: 
Cancer; Hypopharynx; Senegal; Radiotherapy; Chemotherapy
 
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