Keiichi Jingu1,2, Hodaka Numasaki3,4, Yasushi Toh3,5, Kenji Nemoto3,6, Takashi Uno3,7, Yuichiro Doki3,8, Hisahiro Matsubara3,9. 1. Japan Esophageal Society, Tokyo, Japan. kjingu-jr@rad.med.tohoku.ac.jp. 2. Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan. kjingu-jr@rad.med.tohoku.ac.jp. 3. Japan Esophageal Society, Tokyo, Japan. 4. Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan. 5. Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan. 6. Department of Radiology, Yamagata University Faculty of Medicine, Yamagata, Japan. 7. Department of Radiology, Chiba University Hospital, Chiba, Japan. 8. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 9. Department of Frontier Surgery, Chiba University, Chiba, Japan.
Abstract
BACKGROUND: There has been no definitive evidence of chemoradiotherapy being superior to radiotherapy alone in patients aged 80 years or older. The purpose of the present study was to evaluate the results of radiotherapy and chemoradiotherapy in patients aged 80 years or older with esophageal cancer in the Japanese Nationwide Cancer Database. METHODS: A total of 358 patients aged 80 years or older who were treated with radiotherapy alone or with chemoradiotherapy for esophageal cancer between 2009 and 2011 were enrolled. RESULTS: The 5-year overall survival (OS) rates in patients with cStages 0-I, II, III and IV were 40.9%, 24.7%, 12.2% and 4.9%, respectively. The 5-year cause-specific survival (CSS) rates in patients aged 80 years or older with cStages 0-I, cStage II, cStage III and cStage IV were 73.5%, 41.4%, 25.3% and 7.4%, respectively. In patients treated with radiotherapy alone, the 5-year OS rates for patients with cStages 0-I, II, III and IV were 36.5%, 12.0%, 5.4% and 0%, respectively. In patients treated with chemoradiotherapy, the 5-year OS rates for patients with cStages 0-I, II, III and IV were 45.0%, 36.1%, 16.4% and 7.1%, respectively. In multivariate analysis, chemoradiotherapy, early stage and squamous cell carcinoma were significantly favorable prognostic factors for OS in patients aged 80 years or older (p < 0.001, p < 0.001 and p = 0.0323, respectively). We were unable to evaluate toxicities, because of lack of information in the registry. CONCLUSION: Concurrent chemotherapy with radiotherapy for esophageal cancer in patients aged 80 years or older is a significantly favorable prognostic factor for OS. However, chemoradiotherapy should be carefully selected in elderly patients.
BACKGROUND: There has been no definitive evidence of chemoradiotherapy being superior to radiotherapy alone in patients aged 80 years or older. The purpose of the present study was to evaluate the results of radiotherapy and chemoradiotherapy in patients aged 80 years or older with esophageal cancer in the Japanese Nationwide Cancer Database. METHODS: A total of 358 patients aged 80 years or older who were treated with radiotherapy alone or with chemoradiotherapy for esophageal cancer between 2009 and 2011 were enrolled. RESULTS: The 5-year overall survival (OS) rates in patients with cStages 0-I, II, III and IV were 40.9%, 24.7%, 12.2% and 4.9%, respectively. The 5-year cause-specific survival (CSS) rates in patients aged 80 years or older with cStages 0-I, cStage II, cStage III and cStage IV were 73.5%, 41.4%, 25.3% and 7.4%, respectively. In patients treated with radiotherapy alone, the 5-year OS rates for patients with cStages 0-I, II, III and IV were 36.5%, 12.0%, 5.4% and 0%, respectively. In patients treated with chemoradiotherapy, the 5-year OS rates for patients with cStages 0-I, II, III and IV were 45.0%, 36.1%, 16.4% and 7.1%, respectively. In multivariate analysis, chemoradiotherapy, early stage and squamous cell carcinoma were significantly favorable prognostic factors for OS in patients aged 80 years or older (p < 0.001, p < 0.001 and p = 0.0323, respectively). We were unable to evaluate toxicities, because of lack of information in the registry. CONCLUSION: Concurrent chemotherapy with radiotherapy for esophageal cancer in patients aged 80 years or older is a significantly favorable prognostic factor for OS. However, chemoradiotherapy should be carefully selected in elderly patients.