Treatment strategy for simultaneous double primary advanced cancers of the head and neck and the esophagus

Abstract

Double primary cancers of the head and neck and the esophagus are often caused by field cancerization. It is difficult to determine the treatment strategy for cases of synchronous double cancers not indicated for endoscopic resection. We investigated 20 cases of synchronous double primary cancers of the head and neck and the esophagus without indications for endoscopic resection. Treatments for head and neck cancer were chemoradiotherapy in 11 cases, operation in 8 cases and best supportive care （BSC） in 1 case. Treatments for esophageal cancer were chemoradiotherapy in 12 cases, operation in 3 cases, induction chemotherapy （ICT） followed chemoradiotherapy in 2 cases, ICT followed by operation in 2 cases, and BSC in 1 case. The 5-year survival rate was 15.8％, and the 3-year survival rate was 31.7％, which were poor results. Three out of four survival cases without recurrence are receiving simultaneous chemoradiotherapy for the head and neck cancer and the esophageal cancer. Multidisciplinary treatment is not always superior in the case of synchronous double primary cancers, and so we should decide different treatment strategies based on whether there is head and neck cancer or esophageal cancer alone.