Abstract
Esophageal squamous cell carcinoma (ESCC) and head/neck squamous cell carcinoma (HNSCC) are very common cancers worldwide, and there is higher incidence of synchronous ESCC/NSCC in Taiwan. The aim of the current study was to investigate the efficacy of different chemotherapy regimens in patients with locally advanced synchronous ESCC/HNSCC who received curative concurrent chemoradiotheapy (CCRT). A total of 75 patients were identified and assigned to one of two groups: 45 patients receiving cisplatin/5-fluorouracil (5-FU) regime in one group and 30 patients receiving a weekly cisplatin regime in the other. Overall survival (OS) was calculated from the date of diagnosis of the ESCC or HNSCC to the date of death from any cause or the most recent follow-up. Kaplan–Meier curves and log-rank tests were used to estimate OS and differences between the two groups, respectively. There was no significant difference in the analysis of OS between the cisplatin/5-FU and the weekly cisplatin groups. However, patients that interrupted their CCRT were found to have worse OS compared to those without interruptions (5.4 months versus 18.8 months, p = 0.002). In subgroup analysis, patients without interruptions of CCRT had a better OS than those with interruptions in the cisplatin/5-FU group (13.0 months versus 5.4 months, p = 0.041) as well as in the weekly cisplatin group (21.4 months versus 5.0 months, p = 0.017). Interruption of CCRT was the only independently poor prognostic factor of OS in the univariate and multivariate (hazard ratio 0.18, p < 0.001) analyses. Most interruption of CCRT resulted from adverse events (AEs) or serious AEs. Although there was no significant difference in the incidence of AEs between these two groups, lower incidence of adverse events was mentioned in the weekly cisplatin group. Our study suggests that interruption of CCRT is an independently poor prognostic factor of OS, and that completion of CCRT without interruption is more important than the choice of chemotherapeutic regimen for patients with synchronous ESCC/HNSCC.
Highlights
Esophageal cancer and head/neck cancer are among the ten most common cancer types worldwide, with squamous cell carcinoma cases accounting for almost 90% of these cancer patients in Eastern Asian countries, such as Japan, Korea, and Taiwan [1,2,3]
The same risk factors are shared by esophageal squamous cell carcinoma (ESCC) and head/neck squamous cell carcinoma (HNSCC), including smoking, alcohol drinking, and betel quid chewing, leading to the development of synchronous or metachronous double cancers in Taiwan [4,5,6,7]
We retrospectively reviewed the ESCC and HNSCC database at the Kaohsiung Chang Gung Memorial Hospital, and a total of 75 patients who received curative concurrent chemoradiotherapy (CCRT) and matched the eligibility criteria were identified
Summary
Esophageal cancer and head/neck cancer are among the ten most common cancer types worldwide, with squamous cell carcinoma cases accounting for almost 90% of these cancer patients in Eastern Asian countries, such as Japan, Korea, and Taiwan [1,2,3]. There have been well-documented treatment guidelines for isolated ESCC or HNSCC, but guidelines focusing on synchronous double cancers are very limited [8,9]. Extent of invasion, and anatomic proximity, the therapeutic modalities for these double cancers vary, including surgical resection, chemotherapy, radiotherapy, concurrent chemoradiotherapy (CCRT), or best supportive care, for isolated cancer or for synchronous double cancers. To the best of our knowledge, there is limited evidence suggesting an optimal chemotherapy regimen for patients with synchronous ESCC/HNSCC who received CCRT with a curative intent, and the difference of efficacy among different chemotherapeutic regimens is still unclear
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
