Mingqiu Chen1, Xiaohong Liu2, Chun Han3, Xin Wang4, Yidian Zhao5, Qingsong Pang6, Xinchen Sun7, Gaofeng Li8, Kaixian Zhang9, Ling Li9, Xueying Qiao3, Yu Lin1, Junqiang Chen10, Zefen Xiao11. 1. Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No. 420, Fumalu Road, Jinan District, Fuzhou City, Fujian Province, People's Republic of China. 2. The Graduate School, Fujian Medical University, Fuzhou, 350122, Fujian, China. 3. Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China. 4. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. 5. Department 4th of Radiation Oncology, Anyang Cancer Hospital, Anyang, 455000, China. 6. Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin, 300060, China. 7. Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. 8. Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing, 100730, China. 9. Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China. 10. Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No. 420, Fumalu Road, Jinan District, Fuzhou City, Fujian Province, People's Republic of China. junqiangc@163.com. 11. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. xiaozefen@sina.com.
Abstract
BACKGROUND: The aim of the present study was to assess the efficacy of concurrent chemoradiotherapy (CRT) or radiotherapy alone (RT-alone) in elderly patients with esophageal squamous cell carcinoma (ESCC). METHODS: The clinical data of patients with ESCC treated with RT-alone or CRT were collected and retrospectively reviewed. The 1-, 3- and 5-year overall survival (OS) rates and the clinical characteristics correlated with survival were analyzed statistically. Propensity score matching (PSM) analyses were used to compensate for differences in baseline characteristics between the CRT and RT-alone groups to confirm the survival difference. RESULTS: A total of 729 patients fulfilling the inclusion criteria were reviewed. Diabetes, primary tumor volume (pTV), primary tumor location (pTLo), clinical T stage,(cT) clinical N stage (cN), clinical M stage (cM) and short-term response to RT were independent factors influencing OS (P = 0.002-0.044). The 5-year OS rate was 26.6, 26.0 and 30.1% in the whole cohort, RT-alone and CRT groups, respectively. The survival difference between RT alone and CRT was not significant before or following PSM. Compared with the corresponding subgroups treated with RT alone, CRT significantly benefited patients with diabetes (P = 0.003), cT4 (P = 0.030) and cN0 (P = 0.049), whereas no benefit was identified between CRT and RT alone in the other subgroups, including cT1-3, cN1, cM, pTLo, pTV, age and gender. CONCLUSIONS: CRT with the current chemotherapy regimens may not improve the survival of elderly ESCC patients compared to RT-alone, except in patients with cT4 stage, cN0 stage or diabetes. However, due to the limitation of the retrospective nature of the current study, further clinical trials are required for confirmation.
BACKGROUND: The aim of the present study was to assess the efficacy of concurrent chemoradiotherapy (CRT) or radiotherapy alone (RT-alone) in elderly patients with esophageal squamous cell carcinoma (ESCC). METHODS: The clinical data of patients with ESCC treated with RT-alone or CRT were collected and retrospectively reviewed. The 1-, 3- and 5-year overall survival (OS) rates and the clinical characteristics correlated with survival were analyzed statistically. Propensity score matching (PSM) analyses were used to compensate for differences in baseline characteristics between the CRT and RT-alone groups to confirm the survival difference. RESULTS: A total of 729 patients fulfilling the inclusion criteria were reviewed. Diabetes, primary tumor volume (pTV), primary tumor location (pTLo), clinical T stage,(cT) clinical N stage (cN), clinical M stage (cM) and short-term response to RT were independent factors influencing OS (P = 0.002-0.044). The 5-year OS rate was 26.6, 26.0 and 30.1% in the whole cohort, RT-alone and CRT groups, respectively. The survival difference between RT alone and CRT was not significant before or following PSM. Compared with the corresponding subgroups treated with RT alone, CRT significantly benefited patients with diabetes (P = 0.003), cT4 (P = 0.030) and cN0 (P = 0.049), whereas no benefit was identified between CRT and RT alone in the other subgroups, including cT1-3, cN1, cM, pTLo, pTV, age and gender. CONCLUSIONS: CRT with the current chemotherapy regimens may not improve the survival of elderly ESCCpatients compared to RT-alone, except in patients with cT4 stage, cN0 stage or diabetes. However, due to the limitation of the retrospective nature of the current study, further clinical trials are required for confirmation.