title: Clinical results of definitive chemoradiotherapy for patients with synchronous head and neck squamous cell carcinoma and esophageal cancer.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Radiology, National Kyushu Cancer Center, Fukuoka, Japan. shinoto@nirs.go.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Toh
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Higaki
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Kayoko
authors.initials: K
authors.lastname: Ohnishi
authors.forename: Kazushige
authors.initials: K
authors.lastname: Atsumi
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D010094:Oxonic Acid / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D011725:Pyridines; D005641:Tegafur; C489337:potassium oxonate; D010094:Oxonic Acid; D002945:Cisplatin; D005472:Fluorouracil; C104201:gimeracil