Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 8 (1), 28-39

Feasibility and Efficiency of Concurrent Chemoradiotherapy With a Single Agent or Double Agents vs Radiotherapy Alone for Elderly Patients With Esophageal Squamous Cell Carcinoma: Experience of Two Centers

Affiliations

Feasibility and Efficiency of Concurrent Chemoradiotherapy With a Single Agent or Double Agents vs Radiotherapy Alone for Elderly Patients With Esophageal Squamous Cell Carcinoma: Experience of Two Centers

Chunyue Huang et al. Cancer Med.

Abstract

The incidence of elderly patients with esophageal cancer (OC) is increasing as the population ages. Until now, the treatment strategy in these patients has been unclear. The aim of our study was to assess the efficiency and tolerance of treatment with radiotherapy alone (RT alone), single-agent-based concurrent chemoradiotherapy (CCRT-1), or double-agent-based concurrent chemoradiotherapy (CCRT-2) in elderly patients (≥65 years) with OC. A total of 271 patients with OC aged 65 years or older were included in this study. The median overall survival (OS), median progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and treatment-related toxicities were assessed. The median OS time for all patients was 23.6 ± 2.3 months, with 2-year survival rates of 48.0 ± 3.0%. The median PFS time was 13.6 ± 1.3 months with the 2-year PFS rate was 33.0 ± 4.0%. Among patients who received CCRT-1, better OS, and PFS were found in patients who received docetaxel than in patients received fluorouracil and platinum. In a subgroup analysis, 118 patients who underwent RT alone had a median OS time of 15.6 ± 1.9 months and median PFS time of 10.4 ± 0.9 months. The median OS time of patients who received CCRT-1 was 28.8 ± 10.1 months compared with 27.8 ± 2.5 months for the patients treated with CCRT-2 (P = 0.537). The similar results were observed for median PFS, with 16.5 ± 3.2 months in the CCRT-1 group and 17.0 ± 2.0 months in the CCRT-2 group (P = 0.321). Grade ≥3 leukocytopenia and grade ≥2 weight loss during treatment occurred in 40.6% and 17.9% of patients, respectively, in the CCRT-2 group, which was higher than that observed in the CCRT-1 group. Our results suggested that CCRT could be considered as an acceptable treatment for elderly patients with OC. The CCRT-1 group presented with a lower incidence of treatment toxicities but comparable survival outcomes, compared to the CCRT-2 group. Docetaxel was superior to fluorouracil and platinum in terms of OS.

Keywords: concurrent chemoradiotherapy; elderly patient; overall survival; progression-free survival; toxicities.

Figures

Figure 1
Figure 1
Overall survival of (A) all patients (n = 271), (B) patients treated with RT alone (n = 118), single‐agent CCRT (n = 56), and double‐agents CCRT (n = 97), (C) patients with stage IVb esophageal cancer (n = 57), (D) patients treated with docetaxel, fluorouracil, or platinum
Figure 2
Figure 2
Progression‐free survival of (A) all patients (n = 271), (B) patients treated with RT alone (n = 118), single‐agent CCRT (n = 56), and double‐agents CCRT (n = 97), (C) patients with stage IVb esophageal cancer (n = 57), (D) patients treated with docetaxel, fluorouracil, or platinum

Similar articles

See all similar articles

Cited by 1 PubMed Central articles

References

    1. Bollschweiler E, Plum P, Monig SP, Hölscher AH. Current and future treatment options for esophageal cancer in the elderly. Expert Opin Pharmacother. 2017;18:1001‐1010. - PubMed
    1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66:115‐132. - PubMed
    1. Trivers KF, Sabatino SA, Stewart SL. Trends in esophageal cancer incidence by histology, United States, 1998–2003. Int J Cancer. 2008;123:1422‐1428. - PubMed
    1. Remontet L, Esteve J, Bouvier AM, et al. Cancer incidence and mortality in France over the period 1978–2000. Rev Epidemiol Sante Publique. 2003;51:3‐30. - PubMed
    1. Steyerberg EW, Neville B, Weeks JC, Earle CC. Referral patterns, treatment choices, and outcomes in locoregional esophageal cancer: a population‐based analysis of elderly patients. J CLIN ONCOL. 2007;25:2389‐2396. - PubMed

Publication types

LinkOut - more resources

Feedback