Department of Radiology, National Kyushu Cancer Center, Fukuoka, Japan.
Am J Clin Oncol. 2011 Aug;34(4):362-6. doi: 10.1097/COC.0b013e3181e84b4b.
To assess the efficacy and toxicity of radical chemoradiotherapy for patients with synchronous head and neck squamous cell carcinoma (HNSCC) and esophageal cancer (EC).
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).
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.
Definitive chemoradiotherapy for patients with synchronous HNSCC and EC is feasible with a low mortality rate and acceptable morbidity.
评估同步头颈部鳞状细胞癌（HNSCC）和食管癌（EC）患者根治性放化疗的疗效和毒性。
34 例同步 HNSCC 和 EC 患者主要采用根治性放化疗同时治疗。HNSCC 和 EC 的中位外照射剂量为 70 Gy（范围 60-70.5 Gy），除 2 例舌癌患者分别接受近距离放疗和 60 Gy（范围 45-70 Gy）外。31 例患者接受顺铂和/或 5-氟尿嘧啶或 TS-1（一种将替加氟与 5-氟尿嘧啶的代谢激活前体结合，再加上 5-氯-2,4-二氢吡啶和氧嗪酸钾的口服抗癌药物）同步放化疗。
33 例患者完成了计划治疗。总缓解率为 94%，26 例完全缓解（76%），6 例部分缓解（18%）。中位随访 17.3 个月时，总生存率、疾病特异性生存率和无病生存率分别为 44%、52%和 33%。初始失败模式为 14 例患者（63%）局部失败、3 例患者（13%）区域进展和 6 例患者（27%）远处转移。最常见的急性毒性是骨髓抑制，有 8 例患者发生 3-4 级毒性。3 例患者发生 3 级黏膜炎和咽炎。无患者发生 3 级或以上的迟发性疾病。
同步 HNSCC 和 EC 患者的根治性放化疗具有较低的死亡率和可接受的发病率，是可行的。
