Okamoto Tabito, Katada Chikatoshi, Komori Shouko, Yamashita Keishi, Miyamoto Shunsuke, Kano Koichi, Seino Yutomo, Hosono Hiroshi, Matsuba Hiroki, Moriya Hiromitsu, Sugawara Mitsuhiro, Azuma Mizutomo, Ishiyama Hiromichi, Tanabe Satoshi, Hayakawa Kazushige, Koizumi Wasaburo, Okamoto Makito, Yamashita Taku
Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
Auris Nasus Larynx. 2018 Oct;45(5):1053-1060. doi: 10.1016/j.anl.2017.12.005. Epub 2018 May 8.
Curative synchronous double primary cancers of the head and neck and the esophagus (CSC-HE) are frequently detected, but a standard treatment remains to be established. We studied the clinical course to explore appropriate treatment strategies.
We retrospectively studied consecutive 33 patients who had CSC-HE. The disease stage was classified into 4 groups: group A, early head and neck cancer (HNC) and early esophageal cancer (EC); group B, early HNC and advanced EC; group C, advanced HNC and early EC; and group D, advanced HNC and advanced EC. As induction chemotherapy, the patients received 3 courses of TPF therapy (docetaxel 75mg/m on day 1, cisplatin 75mg/m on day 1, and 5-fluorouracil 750mg/m on days 1-5) at 3-week intervals. The clinical courses and treatment outcomes were studied according to the disease stage of CSC-HE.
The disease stage of CSC-HE was group A in 1 patient (3%), group B in 9 patients (27.3%), group C in 3 patients (9.1%), and group D in 20 patients (60.6%). The median follow-up was 26months, and the 2-year overall survival rate was 67.4%. In groups A, B, and C, the 2-year overall survival rate was 83.3%. In group D, the 2-year overall survival rate was 62.6%. Ten of 20 patients in group D received induction chemotherapy with TPF, and 6 patients were alive and disease free at the time of this writing.
The treatment outcomes of patients with CSC-HE were relatively good. TPF induction chemotherapy might be an effective treatment for patients with advanced HNC and advanced EC.
头颈部与食管的根治性同步双原发癌（CSC-HE）经常被检测到，但标准治疗方案仍有待确立。我们研究了其临床病程以探索合适的治疗策略。
我们回顾性研究了连续33例患有CSC-HE的患者。疾病分期分为4组：A组，早期头颈部癌（HNC）和早期食管癌（EC）；B组，早期HNC和晚期EC；C组，晚期HNC和早期EC；D组，晚期HNC和晚期EC。作为诱导化疗，患者每3周接受3个疗程的TPF治疗（多西他赛75mg/m²于第1天，顺铂75mg/m²于第1天，5-氟尿嘧啶750mg/m²于第1 - 5天）。根据CSC-HE的疾病分期研究临床病程和治疗结果。
CSC-HE的疾病分期为A组1例（3%），B组9例（27.3%），C组3例（9.1%），D组20例（60.6%）。中位随访时间为26个月，2年总生存率为67.4%。在A、B和C组中，2年总生存率为83.3%。在D组中，2年总生存率为62.6%。D组20例患者中有10例接受了TPF诱导化疗，在撰写本文时，6例患者存活且无疾病。
CSC-HE患者的治疗结果相对较好。TPF诱导化疗可能是晚期HNC和晚期EC患者的有效治疗方法。
