Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Nanchang University Queen Mary School, Nanchang 330000, China.
Contrast Media Mol Imaging. 2022 Jul 16;2022:3678441. doi: 10.1155/2022/3678441. eCollection 2022.
Few randomized trials are available to guide clinical management of elderly patients with esophageal cancer. Therefore, treatment approaches for the elderly are challenging.
We believe that chemotherapy and radiotherapy are more effective than radiotherapy alone. We envision that chemotherapy is more effective than radiotherapy alone in elderly patients with esophageal cancer.
Retrospective data of patients aged 70 years and older from 2008 to 2015 at our institution were analyzed. Of 61 eligible patients, 32 received definitive CTR and 29 received RT alone. Progression-free survival (PFS) was 16 months (range, 1-67 months), and the median overall survival was 19 months. Median PFS and OS in the chemoradiotherapy group were 17 months (95% confidence interval (CI), 15.1-24.8 months) and 22 months (95% confidence interval (CI), 20.4-32.7 months), respectively.
The median PFS and OS in the radiotherapy group were 16 months and 16 months, respectively. The OS rates at 1, 2, 3, and 5 years were 82%, 42.6%, 19.7%, and 6.6%, respectively. There was no difference in PFS between CRT and RT, but there was an advantage in OS for CRT. Positive nodules had an effect on PFS and OS.
CRT is effective in elderly patients with nodal invasion of esophageal cancer. Higher radiation doses had an effect on PFS and OS, but there was no difference in PFS and OS between CRT and RT. Therefore, treatment approaches for the elderly are challenging.
目前仅有少数随机试验可用于指导老年食管癌患者的临床管理，因此，老年患者的治疗方法颇具挑战性。
我们认为化疗和放疗比单纯放疗更有效。我们设想，对于患有食管癌的老年患者，化疗比单纯放疗更有效。
回顾性分析了 2008 年至 2015 年我院 70 岁及以上的患者数据。61 名符合条件的患者中，32 名接受了根治性放化疗（CTR），29 名接受了单纯放疗（RT）。无进展生存期（PFS）为 16 个月（范围为 1-67 个月），中位总生存期为 19 个月。化疗组的中位 PFS 和 OS 分别为 17 个月（95%置信区间（CI）：15.1-24.8 个月）和 22 个月（95%CI：20.4-32.7 个月）。
放疗组的中位 PFS 和 OS 分别为 16 个月和 16 个月。1、2、3 和 5 年的 OS 率分别为 82%、42.6%、19.7%和 6.6%。CRT 和 RT 之间的 PFS 无差异，但 CRT 在 OS 方面具有优势。阳性结节对 PFS 和 OS 有影响。
CRT 对有淋巴结侵犯的老年食管癌患者有效。更高的放射剂量对 PFS 和 OS 有影响，但 CRT 和 RT 之间的 PFS 和 OS 无差异。因此，老年患者的治疗方法颇具挑战性。
