285 cases of primary squamous cell carcinoma of pyriform sinus were treated by initial surgery completed by radiation. 242 patients received neo-adjuvant chemotherapy: Bleomycin as single agent (n = 95), Vincristine-Methotrexate-Bleomycin or Endoxan: 3 courses (n = 98), CDDP-Bleomycin, 5 FU or Methotrexate: 3 courses (n = 40). Chemotherapy was not administrated to 43 patients. Actuarial survival at 3 years without chemotherapy was 30%, after Bleomycin: 31%, VMB-VME: 47%, CMB-CFB: 61%. The 5-year survival without chemotherapy was 17%, with Bleomycin: 28%, with VMB-VME: 32%. Actuarial survival at 5-year including only deaths due to cancer was 13% without chemotherapy, 29% with Bleomycin and 39% with VMB-VME. This increasing of survival was directly related to improvement of locoregional prognosis.