A retrospective study of definitive chemoradiotherapy for elderly patients with esophageal cancer.
OBJECTIVE
The efficacy and safety of definitive chemoradiotherapy (CRT) for elderly patients with esophageal cancer have not been fully elucidated yet. We conducted a retrospective comparison of the outcomes of CRT between elderly and nonelderly patients with Stage II-III (non-T4) esophageal cancer.


METHODS
There were 33 elderly (aged over 71) patients and 145 nonelderly (aged under 70) patients who fulfilled the selection criteria. The treatment consisted of the continuous infusion of fluorouracil (5-FU) and the intravenous infusion of cisplatin (CDDP) combined with 60 Gy of radiation.


RESULTS
Although the CR rate was almost identical between the 2 groups (63.6% vs. 63.4%, respectively), the recurrence rate after CR was higher in the elderly patients group than in the nonelderly patients group (47.6% vs. 33.7%, P = 0.32). The elderly patient group showed a significantly inferior survival in comparison to the nonelderly patient group with a median survival time (14.7 months vs. 35.1 months, P = 0.01). Discontinuations at the end of CRT were more frequent in the elderly patient group than in the nonelderly patients (57.6% vs. 17.3%, P = 0.01). In addition, over Grade 3 hematologic adverse events were more frequently observed in elderly patients than in nonelderly patients. There were no obvious differences in patients who died of causes other than primary disease.


CONCLUSIONS
This retrospective analysis revealed a significantly inferior efficacy even in selected elderly patients. Although improving the dose intensity of CRT should be desirable even in elderly patients, it seems to be difficult because of more substantial toxicity in elderly patients.
Takeuchi
Satoshi
S
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan. stakeuch@east.ncc.go.jp
Ohtsu
Atsushi
A
Doi
Toshihiko
T
Kojima
Takashi
T
Minashi
Keiko
K
Mera
Kiyomi
K
Yano
Tomonori
T
Tahara
Makoto
M
Muto
Manabu
M
Nihei
Keiji
K
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002423:Cause of Death; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D015897:Comorbidity; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006402:Hematologic Diseases / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D010349:Patient Compliance; D011829:Radiation Dosage; D012189:Retrospective Studies; D015996:Survival Rate
D002945:Cisplatin; D005472:Fluorouracil