Department of Radiation Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230001 Hefei, Anhui, China.
Department of Radiation Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230001 Hefei, Anhui, China.
Cancer Radiother. 2022 Nov;26(8):1064-1069. doi: 10.1016/j.canrad.2022.04.007. Epub 2022 Jul 19.
This single-center retrospective study aimed to observe survival and prognosis of elderly patients with esophageal cancer receiving radical radiotherapy combined with S1 chemotherapy, and to preliminarily explore whether hematologic indicators or inflammatory indicators before radiotherapy are prognostic factors.
We retrospectively collected data of 80 elderly patients with esophageal cancer who had received radical concurrent chemoradiotherapy from January 2015 to July 2018. The patients were older than 70 years. Radiation therapy was delivered with intensity-modulated irradiation therapy (IMRT) or volumetric modulated arc therapy (VMAT), while the chemotherapy regimen was S1 alone. Toxicities were evaluated in accordance with the criteria of the Radiation Therapy Oncology Group. Baseline hematologic basic nutritional indicators, such as hemoglobin (HGB), albumin (ALB), and prealbumin (PAB), along with inflammatory indicators, such as the ratio of neutrophils to lymphocytes (NLR), the ratio of platelets to lymphocytes (PLR), were collected to preliminarily analyze their relationship with progression and survival.
The median follow-up time was 39 months (range 30-65 months). The median overall survival and progression-free survival times were 24 and 17 months, respectively. The 1-, 2-, and 3-year overall survival rates were 76.5%, 48.1%, and 31.3%, respectively. The 1-, 2-, and 3-year progression-free survival rates were 57.5%, 37.8%, and 29.4%, respectively. T stage, clinical staging, and lesion region were independent prognostic factors for OS. No significant associations with prognosis were observed either for baseline hematologic or for inflammatory indicators (all P>0.05). The rates of esophagitis (grade 2 and above) and hematologic toxicity were 60% and 45%, respectively.
Oral S-1 combined with definitive concurrent radiotherapy for elderly patients with esophageal cancer has a significant survival benefit. The toxicities are well tolerated. It seems that prognosis does not correlate with baseline hematologic nutritional indicators and inflammatory indicators.
本单中心回顾性研究旨在观察接受根治性放化疗的老年食管癌患者的生存和预后，并初步探讨放疗前的血液学指标或炎症指标是否为预后因素。
我们回顾性收集了 2015 年 1 月至 2018 年 7 月期间接受根治性同步放化疗的 80 例老年食管癌患者的数据。患者年龄均超过 70 岁。放疗采用调强放疗（IMRT）或容积调强弧形治疗（VMAT），化疗方案为 S1 单药。毒性评估按照放射治疗肿瘤学组（RTOG）的标准进行。收集血红蛋白（HGB）、白蛋白（ALB）和前白蛋白（PAB）等基线血液基本营养指标以及中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）等炎症指标，初步分析其与进展和生存的关系。
中位随访时间为 39 个月（范围 30-65 个月）。中位总生存和无进展生存时间分别为 24 个月和 17 个月。1、2、3 年总生存率分别为 76.5%、48.1%和 31.3%。1、2、3 年无进展生存率分别为 57.5%、37.8%和 29.4%。T 分期、临床分期和病变部位是 OS 的独立预后因素。基线血液学或炎症指标与预后均无显著相关性（均 P>0.05）。食管炎（≥2 级）和血液学毒性的发生率分别为 60%和 45%。
口服 S-1 联合根治性同步放疗治疗老年食管癌患者具有显著的生存获益，毒性可耐受。似乎预后与基线血液学营养指标和炎症指标无关。
