title: Radio(chemo)therapy in Elderly Patients with Esophageal Cancer: A Feasible Treatment with an Outcome Consistent with Younger Patients.
abstract: BACKGROUND
  Although the prevalence of esophageal cancer increases in elderly patients, its clinical history and outcome after treatment remain poorly described.
  
  
  METHODS
  Between January 2001 and December 2011, 58 patients (pts) older than 75 years received 3D-conformal radiotherapy (mean dose 51 Gy) in two French cancer centers. 47/58 (82%) patients received concomitant chemotherapy (with CDDP and/or FU regimens) and 8 patients underwent surgery after primary radiochemotherapy (RCT).
  
  
  RESULTS
  Median age was 77.9 years and the performance status (PS) was 0 or 1 in 89%. Tumors were mainly adenocarcinoma of lower esophagus or gastroesophageal junction (n = 51, 89%), T3T4 (n = 54, 95%), and N1 (n = 44, 77%). The mean follow-up was 21.9 months. In the overall population, the median progression-free survival was 9.6 months and median overall survival (OS) was 14.5 months. Using univariate analysis, OS was significantly associated with age (p = 0.048), PS (p < 0.001), and surgery (p = 0.035). 35 (60.3%) and 18 patients (31%) experienced grade 1-2 or 3-4 toxicity, respectively (CTCAE v4.0).
  
  
  CONCLUSIONS
  Radiochemotherapy in elderly patients is a feasible treatment and its outcome is close to younger patient's outcome published in the literature. Surgical resection, after comprehensive geriatric assessment, should be recommended as the standard treatment for adenocarcinoma of lower esophagus or gastroesophageal junction in elderly patients with good PS and low co-morbidity profile, as it is in younger patients.
authors.affiliation: Department of Radiation Oncology, Institut Paoli Calmettes , Marseille , France ; Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois , Lausanne , Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rochigneux
authors.affiliation: Department of Radiation Oncology, Institut Paoli Calmettes , Marseille , France.
authors.forename: Michel
authors.initials: M
authors.lastname: Resbeut
authors.affiliation: Department of Oncogeriatry, Institut Paoli Calmettes , Marseille , France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Rousseau
authors.affiliation: Endoscopic Unit, Institut Paoli Calmettes , Marseille , France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Bories
authors.affiliation: Department of Medical Oncology, Institut Paoli Calmettes , Marseille , France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Raoul
authors.affiliation: Department of Biopathology, Institut Paoli Calmettes , Marseille , France.
authors.forename: Flora
authors.initials: F
authors.lastname: Poizat
authors.affiliation: Department of Radiation Oncology, Institut Paoli Calmettes , Marseille , France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Moureau-Zabotto
keywords: chemoradiotherapy; elderly patients; esophageal neoplasm; esophagectomy; radiotherapy