Mohata Shweta, Kumar H S, Sharma Neeti, Jhakhar Shankar Lal, Beniwal Surendra, Harsh Kamlesh Kumar
Department of Radiotherapy, Acharya Tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan, India.
Department of Medical Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan, India.
J Cancer Res Ther. 2020 Jan-Mar;16(1):116-119. doi: 10.4103/jcrt.JCRT_878_18.
The benefit of definitive chemoradiotherapy (CRT) in elderly patients with locally advanced esophageal cancer is not well established. We perform a single institutional retrospective study of CRT in terms of toxicity in elderly patients (age more than 60 years) as compared with young cohort (age <60 years) in locally advanced nonmetastatic esophageal cancer.
A total 145 of patients, 79 in young age (Group A) and 66 patients of elder age (Group B) with Stage II and III squamous cell carcinoma of the esophagus with ECOG PS of 0-1, who had undergone definitive CRT at our institute from January 2015 to November 2018 were selected for this analysis. Chemotherapy was cisplatin (40 mg/m) given concurrently on weekly basis with radiotherapy (RT). Total prescribed dose of RT was 50.4 Gy at the rate of 1.8 Gy per fraction. Median age was 40 years (25-60 years) and 65 years (60-75 years) in young and elderly group, respectively. Follow-up is done at median of 28 months (1-48 months) after treatment.
Acute Grade 2-3 esophagitis was seen in 48.10% in young cohort, while it was 60.6% in older group. Grade 2-3 nausea and vomiting was seen in 32.91% in young age patients, while it was 45.5% in elder patients. No statistically significant difference is seen in acute treatment-related toxicity in young and elderly group.
Our conclusion is that patients with adequate functional status should not be excluded from curative CRT based on age alone.
对于老年局部晚期食管癌患者,确定性放化疗(CRT)的获益尚未明确。我们开展了一项单机构回顾性研究,比较老年患者(年龄超过60岁)与年轻队列(年龄<60岁)在局部晚期非转移性食管癌中接受CRT的毒性情况。
选取2015年1月至2018年11月在我院接受确定性CRT的145例患者,其中79例年轻患者(A组)和66例老年患者(B组),均为食管鳞状细胞癌Ⅱ期和Ⅲ期,东部肿瘤协作组(ECOG)体能状态评分为0 - 1。化疗采用顺铂(40mg/m²),每周与放疗(RT)同步进行。RT的总处方剂量为50.4Gy,每次分割剂量为1.8Gy。年轻组和老年组的中位年龄分别为40岁(25 - 60岁)和65岁(60 - 75岁)。治疗后中位随访28个月(1 - 48个月)。
年轻队列中48.10%出现急性2 - 3级食管炎,而老年组为60.6%。年轻患者中32.91%出现2 - 3级恶心和呕吐,老年患者中为45.5%。年轻组和老年组在急性治疗相关毒性方面未见统计学显著差异。
我们的结论是,仅基于年龄,不应将功能状态良好的患者排除在根治性CRT之外。