Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective review
Abstract Background This study aimed to assess the clinical outcomes and prognostic factors of patients with synchronous head and neck squamous cell carcinoma (HNSCC) and esophageal squamous cell carcinoma (ESCC) who underwent simultaneous concurrent chemoradiotherapy (CCRT) and esophagectomy. Metho...
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BMC
2025-07-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-025-02681-0 |
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| author | Yu-Ming Huang Yi-Shing Leu Jehn-Chuan Lee Chao-Hung Chen Hung-Chang Liu Chih-Hao Chen Huan-Chau Lin Nai-Wen Su Wen-Chien Huang Yu-Jen Chen |
| author_facet | Yu-Ming Huang Yi-Shing Leu Jehn-Chuan Lee Chao-Hung Chen Hung-Chang Liu Chih-Hao Chen Huan-Chau Lin Nai-Wen Su Wen-Chien Huang Yu-Jen Chen |
| author_sort | Yu-Ming Huang |
| collection | DOAJ |
| description | Abstract Background This study aimed to assess the clinical outcomes and prognostic factors of patients with synchronous head and neck squamous cell carcinoma (HNSCC) and esophageal squamous cell carcinoma (ESCC) who underwent simultaneous concurrent chemoradiotherapy (CCRT) and esophagectomy. Methods Thirty-one patients who underwent simultaneous CCRT for synchronous HNSCC and ESCC were retrospectively reviewed. The treatment strategy involved simultaneous definitive CCRT at 70 Gy/35 fractions for HNSCC and neoadjuvant CCRT at 48 Gy/24 fractions for ESCC. Esophagectomy was evaluated 4–5 weeks after neoadjuvant CCRT. The radiotherapy plan utilized a simultaneously integrated boost technique at 4–5 dose levels. Patients received weekly platinum chemotherapy during CCRT. Patient characteristics, treatment responses, and survival rates were analyzed. Survival analysis was conducted using the Kaplan–Meier method and Cox regression analyses. Results All the patients completed CCRT at the planned doses and radiation fields with a good tolerance profile. The 1- and 2-year survival rates were 62.9% and 34.4%, respectively. Performance status (PS), ESCC tumor location, HNSCC clinical stage, and clinical responses of HNSCC and ESCC, both individually and combined, were significantly associated with prognosis. PS and the clinical response of ESCC were significant predictors of overall survival. Adverse effects were manageable, with up to eleven patients (35.5%) developing grade 3/4 neutropenia. No treatment-related mortality was noted. Conclusions The treatment strategy using simultaneous definitive CCRT for HNSCC and neoadjuvant CCRT for ESCC followed by esophagectomy for synchronous HNSCC and ESCC is effective and well-tolerated. PS and clinical response of ESCC are significant prognostic factors for this treatment strategy. |
| format | Article |
| id | doaj-art-2ee9eabb2f4542738142fc0322437ea9 |
| institution | Kabale University |
| issn | 1748-717X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj-art-2ee9eabb2f4542738142fc0322437ea92025-08-20T03:42:56ZengBMCRadiation Oncology1748-717X2025-07-0120111110.1186/s13014-025-02681-0Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective reviewYu-Ming Huang0Yi-Shing Leu1Jehn-Chuan Lee2Chao-Hung Chen3Hung-Chang Liu4Chih-Hao Chen5Huan-Chau Lin6Nai-Wen Su7Wen-Chien Huang8Yu-Jen Chen9Department of Radiation Oncology, Taipei Hospital, Ministry of Health and WelfareDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Medicine, MacKay Medical CollegeDepartment of Radiation Oncology, MacKay Memorial HospitalAbstract Background This study aimed to assess the clinical outcomes and prognostic factors of patients with synchronous head and neck squamous cell carcinoma (HNSCC) and esophageal squamous cell carcinoma (ESCC) who underwent simultaneous concurrent chemoradiotherapy (CCRT) and esophagectomy. Methods Thirty-one patients who underwent simultaneous CCRT for synchronous HNSCC and ESCC were retrospectively reviewed. The treatment strategy involved simultaneous definitive CCRT at 70 Gy/35 fractions for HNSCC and neoadjuvant CCRT at 48 Gy/24 fractions for ESCC. Esophagectomy was evaluated 4–5 weeks after neoadjuvant CCRT. The radiotherapy plan utilized a simultaneously integrated boost technique at 4–5 dose levels. Patients received weekly platinum chemotherapy during CCRT. Patient characteristics, treatment responses, and survival rates were analyzed. Survival analysis was conducted using the Kaplan–Meier method and Cox regression analyses. Results All the patients completed CCRT at the planned doses and radiation fields with a good tolerance profile. The 1- and 2-year survival rates were 62.9% and 34.4%, respectively. Performance status (PS), ESCC tumor location, HNSCC clinical stage, and clinical responses of HNSCC and ESCC, both individually and combined, were significantly associated with prognosis. PS and the clinical response of ESCC were significant predictors of overall survival. Adverse effects were manageable, with up to eleven patients (35.5%) developing grade 3/4 neutropenia. No treatment-related mortality was noted. Conclusions The treatment strategy using simultaneous definitive CCRT for HNSCC and neoadjuvant CCRT for ESCC followed by esophagectomy for synchronous HNSCC and ESCC is effective and well-tolerated. PS and clinical response of ESCC are significant prognostic factors for this treatment strategy.https://doi.org/10.1186/s13014-025-02681-0Synchronous head and neck squamous cell carcinoma and esophageal squamous cell carcinomaConcurrent chemoradiotherapySimultaneous integrated boostPerformance statusClinical response |
| spellingShingle | Yu-Ming Huang Yi-Shing Leu Jehn-Chuan Lee Chao-Hung Chen Hung-Chang Liu Chih-Hao Chen Huan-Chau Lin Nai-Wen Su Wen-Chien Huang Yu-Jen Chen Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective review Radiation Oncology Synchronous head and neck squamous cell carcinoma and esophageal squamous cell carcinoma Concurrent chemoradiotherapy Simultaneous integrated boost Performance status Clinical response |
| title | Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective review |
| title_full | Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective review |
| title_fullStr | Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective review |
| title_full_unstemmed | Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective review |
| title_short | Simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma: a retrospective review |
| title_sort | simultaneous concurrent chemoradiotherapy and esophagectomy for synchronous head and neck and esophageal squamous cell carcinoma a retrospective review |
| topic | Synchronous head and neck squamous cell carcinoma and esophageal squamous cell carcinoma Concurrent chemoradiotherapy Simultaneous integrated boost Performance status Clinical response |
| url | https://doi.org/10.1186/s13014-025-02681-0 |
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