Feasibility and treatment outcomes ofsimultaneous definitive chemoradiotherapy for elderly patients with synchronous hypopharyngeal and esophageal squamous cell carcinoma

Sep 22, 2026

Hypopharyngeal and esophageal squamous cell carcinoma can occur synchronously, yet optimal management for elderly patients remains unclear. This single-institution retrospective study assessed feasibility and outcomes of simultaneous definitive chemoradiotherapy in patients aged 65+ treated for synchronous hypopharyngeal and esophageal squamous cell carcinomas between 2002 and 2022. Fifteen patients received 3D conformal radiotherapy with concurrent chemotherapy; treatment completion was high, responses were complete or partial, overall survival and progression-free survival at 2 years were 56%, and grade 2+ adverse events were tolerable.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Rationale and background

Available treatment options

Evidence and knowledge gaps

Methods (from study summary)

Patient population and study design

Radiotherapy and concurrent chemotherapy

Results (from study summary)

Treatment completion and response

Survival outcomes

Adverse events

Conclusion

Journal of Radiation Research, Vol. 67, No. 3, 2026, pp. 436–443 [https://doi.org/10.1093/jrr/rrag023](https://doi.org/10.1093/jrr/rrag023) Advance Access Publication: 22 April 2026 Feasibility and treatment outcomes ofsimultaneous definitive chemoradiotherapy for elderly patients with synchronous hypopharyngeal and esophageal squamous cell carcinoma Yuki Wada1, * , Tetsugaku Shinozaki1, Satoshi Kumagai1, Tasuku Kume1, Tomochika Sato 1, Noriko Takagi1, Akiyuki Wakita2 , Yusuke Sato2, Yohei Kawasaki3, Takechiyo Yamada3, Tamotsu Matsuhashi4, Katsunori Iijima4 and Naoko Mori1 1Department of Radiology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan 2Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan 3Department of Otorhinolaryngology, Head and Neck Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan 4Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan *Corresponding author. Department of Radiology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan. Tel: +81-18-834-1111; Fax: +81-18-836-2623; [Email: ywada@med.akita-u.ac.jp](Email: ywada@med.akita-u.ac.jp) (Received 16 January 2026; revised 15 February 2026; accepted 10 March 2026) 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 ofsimultaneous definitive chemoradiotherapy in this population. This single-institution retrospective studyincluded patients aged ≥65 years who received definitive chemoradiotherapy for synchronous hypopharyngeal and esophageal squamous cell carcinomas between January2002 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 temporaryradiotherapy suspension. Thirteenpatients (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. Keywords: synchronous cancer; minimally invasive treatment; head and neck cancer; esophageal cancer; elderly patient © The Author(s) 2026. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://creativecommons.org/licenses/by](https://creativecommons.org/licenses/by)nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact repr[ints@oup.com](ints@oup.com) for r

FAQs

What clinical problem does the study address for elderly patients?

The study evaluates feasibility and treatment outcomes of simultaneous definitive chemoradiotherapy for elderly patients with synchronous hypopharyngeal and esophageal squamous cell carcinomas.

How was definitive chemoradiotherapy delivered in the study?

Patients received 3D conformal radiotherapy—70 Gy/35 fractions for hypopharyngeal tumors and 60 Gy/30 fractions for esophageal tumors—with concurrent systemic chemotherapy, most commonly cisplatin/fluorouracil.

What were the main outcome and safety findings?

All patients completed planned radiotherapy, responses were complete or partial, 2-year overall survival and progression-free survival were both 56%, and grade 2+ adverse events occurred but were tolerable.

Sep 22, 2026

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