Multimodal treatments for patients with locally advanced synchronous esophageal and head and neck cancer

Background: Head and neck squamous cell carcinoma (HNSCC) andesophageal squamous cell carcinoma (ESCC) sometimes occur synchronously. This study aimed to investigatetreatment profiles including survival outcomes and late adverse events (AEs) in patients with locally advanced synchronous ESCC and HNSCC (LA-SEHNC). Methods: We retrospectively analyzed consecutive patients with LA-SEHNC who underwent curative-intent surgery or chemoradiotherapy (CRT) for HNSCC and ESCC between 2007 and 2024. The patients were classified into 3 groups: Group A, surgery for both HNSCC and ESCC; Group B, CRT for both HNSCC and ESCC; and Group C, CRT for either HNSCC or ESCC. Results: Forty-two patients with LA-SEHNC were identified: 7 in Group A, 28 in Group B,and 7 in Group C. There were no differences in overall survival orrecurrence-free survival among the groups. Late AEs, including stenosis (A 0% / B 51.9% / C 57.1%; p = 0.04), dysphagia (A 0% / B 59.3% / C 42.9%; p = 0.02), and xerostomia (A 14.3%/ B 74.1% / C 57.1%; p = 0.01), occurred more frequently in Groups B and C than in Group A. The median feeding tube dependency duration was significantly longer in Group B than in Group A (80 vs. 0 days; p < 0.01). PS 1-2 and irradiation of the head and neck region were significantly associated with long-term feeding tube dependency (odds ratio [OR]: 9.10, p = 0.005; OR: 7.71e+7, p = 0.024, respectively). Conclusion: Although no significant difference in survival was found among patients with LA-SEHNC regardless of the treatment modality, radiotherapy use may be associated with increased late AEs.