Thoracic Tumor
Prognostic analysis of radical 3 DRT ± chemotherapy in patients with esophageal cancer aged 70years or older
Xue Li, Wencheng Zhang, lujun Zhao, Qinchen Cao, Peng Wang, Ping Wang
Published 2015-03-15
Cite as Chin J Radiat Oncol, 2015, 24(2): 111-115. DOI: 10.3760/cma.j.issn.1004-4221.2015.02.003
Abstract
ObjectiveTo evaluate the efficacy and adverse effects of radical three-dimensional conformal radiotherapy (3DRT)alone or combined with chemotherapy in elderly patients (≥70 years)with esophageal cancer.
MethodsThe clinical data of 116 esophageal cancer patients who were aged 70 years or older and received radical 3 DRT ± chemotherapy from 2008 to 2013 were retrospectively analyzed. Of the 116 patients, 32 received concurrent chemoradiotherapy, 24 received sequential chemoradiotherapy, and 60received radiotherapy alone. Overall survival(OS)and progression-free survival(PFS)rates were determined using the Kaplan-Meier method, and survival difference analysis and univariate prognostic analysis was performed using the log-rank test. Multivariate prognostic analyses were performed using the Cox proportional hazard model.
ResultsThe follow-up rate was 100%. The 2-and 3-year sample sizes were 102 and 77, respectively. The 1-, 2-, and 3-year OS rates were 59.1%, 38.4%, and 23.2%, respectively, and the PFS rates were 61.9%, 37.9%, and 0%, respectively. The median OS for the patients treated with concurrent chemoradiotherapy, sequential chemoradiotherapy, and radiotherapy alone were 22.3, 18.0, and 12.4 months, respectively (P=0.044). The median OS was significantly different between patients treated with 60 Gy and<60 Gy in radiotherapy (24.7 vs. 10.9 months, P=0.036) , but not significantly different between those treated with 60 Gy and >60 Gy (24.7 vs. 18.7 months, P=0.938). Multivariate analysis indicated that sex, presence or absence of combined chemotherapy, and radiotherapy dose were independent influencing factors for OS (P=0.003, 0.042, and 0.037, respectively) .
ConclusionsRadical 3 DRT ± chemotherapy are well tolerated in elderly patients with esophageal cancer and equally effective as in those younger than 70 years. Patients treated with radical concurrent chemoradiotherapy have a better prognosis than those treated with sequential chemoradiotherapy and radiotherapy alone. Radiotherapy with a dose of 60 Gy effectively improves the survival compared with doses less than 60 Gy, which suggests that 60 Gy is the optimal dose in radiotherapy.
Key words:
Esophageal neoplasms / radiochemtherapy; Radiotherapy, three - dimensional; Radiochemtherapy, concurrent; Radiochemtherapy, sequential; Prognosis
Contributor Information
Xue Li
Departments of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Oncology Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center of Cancer, Tianjin 300060, China
Wencheng Zhang
lujun Zhao
Qinchen Cao
Peng Wang
Ping Wang
