ABSTRACT Hypopharyngeal and esophageal squamous cell carcinoma may occur synchronously; however, optimal treatment strategies, particularly for elderly patients, remain undefined. We evaluated the feasibility and outcomes of simultaneous definitive chemoradiotherapy in this population. This single-institution retrospective study included patients aged ≥65 years who received definitive chemoradiotherapy for synchronous hypopharyngeal and esophageal squamous cell carcinomas between January 2002 and December 2022. Definitive chemoradiotherapy completion rate, objective response, overall survival, progression-free survival and adverse events were assessed. Fifteen patients were included (median age, 71 years; range, 67–85); all patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The clinical stages of the carcinomas ranged from early to locally advanced, with the hypopharynx being the advanced site in seven patients (47%), the esophagus in six (40%) and both sites equally in two (13%). The definitive chemoradiotherapy regimen comprised three-dimensional conformal radiotherapy with 70 Gy in 35 fractions for hypopharyngeal carcinomas and 60 Gy in 30 fractions for esophageal carcinomas, with concurrent systemic chemotherapy, the most common being cisplatin/fluorouracil (seven patients, 47%). All patients completed the planned radiotherapy; although six patients (40%) required temporary radiotherapy suspension. Thirteen patients (87%) completed the planned chemotherapy. All patients achieved complete or partial response. The 2-year overall survival and progression-free survival rates were both 56%. All patients experienced grade ≥ 2 adverse events, but they were tolerable. Simultaneous definitive chemoradiotherapy is feasible and demonstrates favorable outcomes for elderly patients with synchronous hypopharyngeal and esophageal squamous cell carcinomas.
Wada et al. (Thu,) studied this question.