Original Article
Establishment of treatment strategy and preliminary outcome for synchronous head and neck and thoracic esophageal squamous cell carcinoma
Abstract
Background: The optimal treatment strategy for synchronous head and neck squamous cell carcinoma (HNSCC) and esophageal squamous cell carcinoma (ESCC) remains controversial. We aimed to examine the preliminary outcome by a strategy using simultaneous chemoradiation (CCRT) and putative esophagectomy.
Methods: This study included 12 patients treated for synchronous HNSCC and ESCC from January 2014 to July 2017. All patients were treated by simultaneous CCRT except 1 RT alone. Intensity modulated radiation therapy (IMRT) with 2-step simultaneous integrated boost (SIB) technique was delivered in 9 patients and the others received 3-step non-SIB treatment. There were 6, 5 and 1 patients received neoadjuvant CCRT, definitive CCRT/RT and adjuvant CCRT, respectively.
Results: All patients completed and tolerated the IMRT as planned dose and fields. The 1- and 2-year survival rates were 51.1% and 34.1%, respectively. All recurrences were developed within regions of esophageal tumor bed and periesophageal lymph nodes. In neoadjuvant CCRT setting, surgery was performed in 3 patients, all of which had pathological complete response. No leakage at anastomosis site was noted.
Conclusions: The treatment strategy by using simultaneous CCRT and putative esophagectomy for synchronous HNSCC and ESCC with comprehensive dosimetry consideration may provide a practical clinical pathway for further investigation.
Methods: This study included 12 patients treated for synchronous HNSCC and ESCC from January 2014 to July 2017. All patients were treated by simultaneous CCRT except 1 RT alone. Intensity modulated radiation therapy (IMRT) with 2-step simultaneous integrated boost (SIB) technique was delivered in 9 patients and the others received 3-step non-SIB treatment. There were 6, 5 and 1 patients received neoadjuvant CCRT, definitive CCRT/RT and adjuvant CCRT, respectively.
Results: All patients completed and tolerated the IMRT as planned dose and fields. The 1- and 2-year survival rates were 51.1% and 34.1%, respectively. All recurrences were developed within regions of esophageal tumor bed and periesophageal lymph nodes. In neoadjuvant CCRT setting, surgery was performed in 3 patients, all of which had pathological complete response. No leakage at anastomosis site was noted.
Conclusions: The treatment strategy by using simultaneous CCRT and putative esophagectomy for synchronous HNSCC and ESCC with comprehensive dosimetry consideration may provide a practical clinical pathway for further investigation.
