Response to concurrent chemoradiotherapy as a prognostic marker in elderly patients with locally advanced esophageal cancer.
OBJECTIVE
Little is known about chemoradiotherapy in elderly patients with locally advanced esophageal cancer. We compared the efficacy and toxicity of chemoradiotherapy in elderly and non-elderly patients with locally advanced esophageal cancer and determined the variables affecting the treatment outcome in the elderly patients with locally advanced esophageal cancer who had received chemoradiotherapy.


METHODS
Fifty-seven elderly patients (age ≥ 65 years) and 30 non-elderly patients (age <65 years) were reviewed retrospectively.


RESULTS
The median age of the elderly group was 69 years and in the non-elderly group, 56.5 years. Although treatment compliance appeared to be poor, the response rate and median survival were similar in both the groups (elderly versus non-elderly; 84.4% vs 87.5%, and 11.2 months vs 11.3 months) and so were G3/4 hematologic and non-hematologic toxicities. The treatment-related mortality of the elderly patients appeared to be higher than that of the non-elderly group (7.0% vs 3.3%), but did not reach statistical significance. In prognostic factor analysis, a major response to chemoradiotherapy was a good prognostic indicator in the elderly group (response versus non-response; median overall survival times of 19.5 vs 5.4 months, respectively, P <0.001).


CONCLUSIONS
The study suggests that chemoradiotherapy for locally advanced esophageal cancer in elderly patients, even though treatment compliance appears to be poor, is as safe and effective as in non-elderly patients and that the response to chemoradiotherapy is related to prognosis in elderly patients.
Departments of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Se-Il
SI
Go
Won
W
Sup Lee
Myung
M
Hee Kang
Haa-Na
HN
Song
Moon
M
Jin Kim
Min
M
Jeong Lee
Hoon-Gu
HG
Kim
Gyeong
G
Won Lee
Jung
J
Hun Kang
Jeong-Hee
JH
Lee
Ki
K
Mun Kang
Kyung-Nyeo
KN
Jeon
Jae
J
Min Cho
Woon
W
Tae Jung
Gyung
G
Hyuck Ko
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome