Tougeron D, Di Fiore F, Thureau S, Berbera N, Iwanicki-Caron I, Hamidou H, Paillot B, Michel P
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, Northwest Canceropole, Rouen Cedex, France.
Br J Cancer. 2008 Nov 18;99(10):1586-92. doi: 10.1038/sj.bjc.6604749. Epub 2008 Oct 28.
Little is known about chemoradiotherapy (CRT) in elderly patients with a locally advanced oesophageal cancer (OC). The aim of our study was to evaluate the tolerance and the outcome of elderly patients older than 70 years treated with CRT for a non-metastatic OC. Chemoradiotherapy was based on radiotherapy combined with a cisplatin-based chemotherapy. Clinical complete response (CCR) to CRT was evaluated on upper digestive endoscopy and computed tomography scan 6-8 weeks after CRT completion. One hundred and nine consecutive patients were included. A CCR was observed in 63 patients (57.8%) and 2-year survival was 35.5%. Adverse events > or =grade 3 were observed in 26 (23.8%) patients. Chemotherapy dose reduction, chemotherapy delays more than 1 week, and treatment discontinuation were observed in 33 (30.3%), 45 (41.3%), and 17 patients (15.6%), respectively. Comorbidity index according to Charlson score was significantly associated with treatment tolerance. In multivariate analysis, a CCR to CRT (P<0.01), a dose of radiotherapy > or =80% (P=0.02), and a Charlson score < or =2 (P=0.046) were identified as independent prognostic factors of overall survival. These results suggest that CRT could be considered as an effective treatment without major toxicity in elderly patients with OC.
关于老年局部晚期食管癌（OC）患者的放化疗（CRT），目前了解甚少。我们研究的目的是评估70岁以上老年非转移性OC患者接受CRT治疗的耐受性和疗效。放化疗基于放疗联合以顺铂为基础的化疗。在CRT完成后6 - 8周，通过上消化道内镜检查和计算机断层扫描评估对CRT的临床完全缓解（CCR）。纳入了109例连续患者。63例患者（57.8%）观察到CCR，2年生存率为35.5%。26例（23.8%）患者观察到≥3级不良事件。分别有33例（30.3%）、45例（41.3%）和17例（15.6%）患者出现化疗剂量减少、化疗延迟超过1周和治疗中断。根据Charlson评分的合并症指数与治疗耐受性显著相关。在多变量分析中，CRT的CCR（P<0.01）、放疗剂量≥80%（P = 0.02）和Charlson评分≤2（P = 0.046）被确定为总生存的独立预后因素。这些结果表明，CRT可被视为老年OC患者一种有效的、无重大毒性的治疗方法。
