Clinical results of definitive chemoradiotherapy for patients with synchronous head and neck squamous cell carcinoma and esophageal cancer

Makoto Shinoto, Yoshiyuki Shioyama, Tomonari Sasaki, Katsumasa Nakamura, Hiroki Ohura, Yasushi Toh, Yuichiro Higaki, Toshihiro Yamaguchi, Kayoko Ohnishi, Kazushige Atsumi, Hideki Hirata, Hiroshi Honda

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Abstract

Objectives: To assess the efficacy and toxicity of radical chemoradiotherapy for patients with synchronous head and neck squamous cell carcinoma (HNSCC) and esophageal cancer (EC). Methods: Thirty-four patients with synchronous HNSCC and EC were treated mainly with radical chemoradiotherapy at the same time. Median external radiation dose for HNSCC and EC was 70 Gy (range, 60-70.5 Gy), except for 2 patients with tongue cancer, who underwent brachytherapy and 60 Gy (range, 45-70 Gy), respectively. Thirty-one patients were treated with concurrent chemoradiotherapy with cisplatin and/or 5-fluorouracil or TS-1 (oral anticancer agent that combines tegafur, a metabolically activated prodrug of 5-fluorouracil, with 5-chloro-2, 4-dihydoroxypyridine, and potassium oxonate). Results: Thirty-three patients completed the intended treatment. The response rate was 94%, with 26 complete responses (76%) and 6 partial responses (18%). At a median follow-up of 17.3 months, 2-year rates of overall survival, cause-specific survival, and disease-free survival were 44%, 52%, and 33%, respectively. Initial failure patterns were local failure in 14 patients (63%), regional progression in 3 patients (13%), and distant metastasis in 6 patients (27%). The most common acute toxicity was myelosuppression, with 8 patients experiencing grade 3-4 toxicity. Three patients experienced grade 3 mucositis and pharyngitis. No patients experienced late morbidity of grade 3 or higher. Conclusions: Definitive chemoradiotherapy for patients with synchronous HNSCC and EC is feasible with a low mortality rate and acceptable morbidity.

Original languageEnglish
Pages (from-to)362-366
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume34
Issue number4
DOIs
Publication statusPublished - Aug 1 2011

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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