title: Safety and outcome of definitive chemoradiotherapy in elderly patients with oesophageal cancer.
abstract: Little is known about chemoradiotherapy (CRT) in elderly patients with a locally advanced oesophageal cancer (OC). The aim of our study was to evaluate the tolerance and the outcome of elderly patients older than 70 years treated with CRT for a non-metastatic OC. Chemoradiotherapy was based on radiotherapy combined with a cisplatin-based chemotherapy. Clinical complete response (CCR) to CRT was evaluated on upper digestive endoscopy and computed tomography scan 6-8 weeks after CRT completion. One hundred and nine consecutive patients were included. A CCR was observed in 63 patients (57.8%) and 2-year survival was 35.5%. Adverse events > or =grade 3 were observed in 26 (23.8%) patients. Chemotherapy dose reduction, chemotherapy delays more than 1 week, and treatment discontinuation were observed in 33 (30.3%), 45 (41.3%), and 17 patients (15.6%), respectively. Comorbidity index according to Charlson score was significantly associated with treatment tolerance. In multivariate analysis, a CCR to CRT (P<0.01), a dose of radiotherapy > or =80% (P=0.02), and a Charlson score < or =2 (P=0.046) were identified as independent prognostic factors of overall survival. These results suggest that CRT could be considered as an effective treatment without major toxicity in elderly patients with OC.
authors.affiliation: Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, Northwest Canceropole, Rouen Cedex, France. davidtougeron@hotmail.fr
authors.forename: D
authors.initials: D
authors.lastname: Tougeron
authors.forename: F
authors.initials: F
authors.lastname: Di Fiore
authors.forename: S
authors.initials: S
authors.lastname: Thureau
authors.forename: N
authors.initials: N
authors.lastname: Berbera
authors.forename: I
authors.initials: I
authors.lastname: Iwanicki-Caron
authors.forename: H
authors.initials: H
authors.lastname: Hamidou
authors.forename: B
authors.initials: B
authors.lastname: Paillot
authors.forename: P
authors.initials: P
authors.lastname: Michel
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage*; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin