Prospective trial of radiotherapy for patients 80 years of age or older with squamous cell carcinoma of the thoracic esophagus.
OBJECTIVE
To assess the safety and efficacy of external beam radiotherapy for elderly patients with esophageal cancer.


METHODS
A trial testing external beam radiotherapy (66 Gy within 6.5 weeks) as a single-modality treatment was performed for biopsy-proven squamous cell carcinoma of the thoracic esophagus clinically staged as Stage I and IIA (T1-T3N0M0, International Union Against Cancer, 1987) in patients aged > or =80 years.


RESULTS
From January 1999 through December 2002, 51 evaluable patients (35 men and 16 women) with a median age of 83 years (range, 80-91 years) were enrolled from 22 institutions. Of the 51 patients, 18 (35%) had Stage T1 and 33 (65%) had Stage T2-T3 disease. Radiotherapy could be completed in 47 patients (92%) within 43-58 days (median, 49). The actuarial incidence of Grade 3 or worse cardiopulmonary complications at 3 years was 26%, with 3 early deaths, and correlated significantly with the size of the anteroposterior radiotherapy portals. The median survival time and overall survival rate at 3 years was 30 months and 39% (95% confidence interval, 25-52%), respectively.


CONCLUSIONS
The results of high-dose radiotherapy in octogenarians are comparable to those in younger patients, but meticulous treatment planning and quality control is required.
Kawashima
Mitsuhiko
M
Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan. mkawashi@east.ncc.go.jp
Kagami
Yoshikazu
Y
Toita
Takafumi
T
Uno
Takashi
T
Sugiyama
Masato
M
Tamura
Yoichirio
Y
Hirota
Saeko
S
Fuwa
Nobukazu
N
Hashimoto
Mitsumasa
M
Yoshida
Hiroshi
H
Shikama
Naoto
N
Kataoka
Masaaki
M
Akuta
Keizo
K
Sasaki
Kinro
K
Tamamoto
Tetsuro
T
Nemoto
Kenji
K
Ito
Hisao
H
Kato
Hoichi
H
Yamada
Shogo
S
Ikeda
Hiroshi
H
D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002423:Cause of Death; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D017211:Treatment Failure