Uno Takashi, Isobe Koichi, Kawakami Hiroyuki, Ueno Naoyuki, Kobayashi Hiroki, Shimada Hideaki, Mastubara Hisahiro, Okazumi Shinichi, Nabeya Yoshihiro, Shiratori Touru, Ochiai Takenori, Kawata Tetsuya, Ito Hisao
Department of Radiation Oncology, Chiba University Graduate School of Medicine, Chiba, Japan.
Anticancer Res. 2004 Jul-Aug;24(4):2483-6.
To evaluate the efficacy and toxicity of concurrent chemoradiation in patients with esophageal cancer aged 75 and older.
Twenty-two elderly patients were treated with concurrent chemoradiation. Seventeen received a combination of cisplatin/carboplatin and 5-fluorouracil, 5 received daily 5-fluorouracil. Total doses of radiotherapy ranged from 50 to 65 Gy.
Nineteen out of 22 patients completed the planned chemoradiation. Five in 8 patients (63%) with T1-2 lesion and 1 in 14 patients (7o%) with T3-4 lesion achieved complete response (p=0.011). Only 2 patients experienced grade 3 toxicities. Grade 2 or worse hematological toxicities were less frequently observed in patients who received local-field radiotherapy (p=0.006). There was no isolated lymph node recurrence. The median survival time was 9 months.
This study showed the potential for chemoradiation in elderly patients. A planning target volume of radiotherapy should include only clinically involved lesions in this setting.
评估同步放化疗对75岁及以上老年食管癌患者的疗效和毒性。
22例老年患者接受同步放化疗。17例接受顺铂/卡铂与5-氟尿嘧啶联合治疗，5例接受每日5-氟尿嘧啶治疗。放疗总剂量为50至65 Gy。
22例患者中有19例完成了计划的同步放化疗。8例T1-2期病变患者中有5例（63%）、14例T3-4期病变患者中有1例（7%）达到完全缓解（p=0.011）。仅2例患者出现3级毒性反应。接受局部野放疗的患者较少出现2级或更严重的血液学毒性反应（p=0.006）。无孤立淋巴结复发。中位生存时间为9个月。
本研究显示了同步放化疗在老年患者中的潜力。在此情况下，放疗的计划靶体积应仅包括临床受累病变。
