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Strahlentherapie und Onkologie

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01-03-2012 | Original article

Radiotherapy in elderly patients with inoperable esophageal cancer

Is there a benefit?

Authors: R. Semrau, MD, S.L. Herzog, D. Vallböhmer, M. Kocher, A. Hölscher, R.-P. Müller

Published in: Strahlentherapie und Onkologie | Issue 3/2012

Abstract

Background

Radiation oncologists increasingly face elderly cancer patients impaired by comorbidities and reduced performance status. As less data are available for this particular group of patients, the aim of the study was to assess the prognosis of inoperable esophageal cancer patients ≥ 70 years undergoing definitive radiotherapy or radiochemotherapy.

Patients and treatment protocol

Patients aged ≥ 70 with inoperable carcinoma of the esophagus undergoing definitive radio(chemo)therapy between 1995 and 2006 at the University of Cologne were included retrospectively. Maximal total dose of radiotherapy administered was 63 Gy (5 × 1.8 Gy/week). Chemotherapy consisted of cisplatin (20 mg/m² on days 1–5 and days 29–33) and 5-fluorouracil (650–1,000 mg/m² on days 1–5 and days 29–33). Efficacy was compared with a cohort of 152 patients < 70 years treated with the same protocol during the same time period.

Results

A total of 51 patients aged ≥ 70 with inoperable cancer of the esophagus undergoing definitive therapy were identified (stage I/II 23.5%, stage III 56.9%, stage IV 9.8%; squamous cell carcinoma 74.5%, adenocarcinoma 25.5%). While 15 patients (29.4%) received combined radiochemotherapy (RCT), 40 patients (70.6%) were treated with radiotherapy alone (RT). Median progression-free survival (PFS) was 9.5 months; median overall survival (OS) was 13.9 months. Patients treated with RCT had a 2-year OS rate of 53.3% compared with 16.7% for RT patients (p = 0.039). The 2-year OS for clinically lymph node negative patients was 38.5% compared with 21.2% for lymph node positive patients (p = 0.072). Median OS was not significantly different between patients ≥ 70 years versus the patient cohort (n = 152) aged < 70 years (13.9 vs. 7.2 months, p = 0.072) but PFS showed a significant difference (4.9 vs. 9.5 months, p = 0.026) in favor of the > 70 years group.

Conclusion

Prognosis in elderly patients with inoperable esophageal cancer undergoing definitive radiotherapy/radiochemotherapy is limited, although it is not inferior to patients < 70 years.

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Title: Radiotherapy in elderly patients with inoperable esophageal cancer
Is there a benefit?
Authors: R. Semrau, MD
S.L. Herzog
D. Vallböhmer
M. Kocher
A. Hölscher
R.-P. Müller
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Strahlentherapie und Onkologie / Issue 3/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-011-0039-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Radiotherapy in elderly patients with inoperable esophageal cancer

Is there a benefit?

Abstract

Background

Patients and treatment protocol

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and treatment protocol

Results

Conclusion

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