Yamakawa M, Shiojima K, Takahashi M, Saito Y, Matsumoto H, Mitsuhashi N, Niibe H
Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Japan.
Int J Radiat Oncol Biol Phys. 1994 Dec 1;30(5):1225-32. doi: 10.1016/0360-3016(94)90333-6.
A retrospective analysis was performed to investigate the treatment outcome and the significance of radiation therapy for esophageal cancer in patients over 80 years old.
Between 1971 and 1990, 257 patients with squamous cell carcinoma of the esophagus were treated by radiation therapy. Of these, 40 patients over eighty years old were investigated. The reasons for radiation therapy were advanced age alone in 22 patients, Stage IV disease in 13, and medical problems in 5. Of these, 33 patients (83%) could be irradiated over 60 Gy. The cases with Stage I to III disease who received 60 Gy or more were defined as the curative radiation therapy group, and the others were defined as the palliative radiation therapy group. Actuarial survival rates were determined by the Kaplan-Meier method.
The 5-year disease-specific survival rate for the curative radiation therapy group (n = 25) was 34% with three intercurrent deaths. None of the patients in the palliative radiation therapy group (n = 15), including 13 cases with Stage IV and two given-up cases, survived over 2 years. No severe radiation damage was observed in either group. The 5-year disease-specific survival rate was 64% for complete response cases of local response, and 8% for partial response and no change cases (p < 0.01). The 5-year disease-specific survival rate was 64% for the patients with tumors less than 5 cm in length, and 8% for the patients with tumors over 5 cm in length (p < 0.001). No significant survival differences were found in regard to sex and tumor location. The patients with superficial spreading type and polypoid type tumors according to the radiologic findings had better prognoses than the patients with ulcerative type and circumferential type tumors.
Radiation therapy is a safe and effective treatment for esophageal cancer in patients over 80 years old.
进行一项回顾性分析，以调查80岁以上食管癌患者的治疗结果及放射治疗的意义。
1971年至1990年间，257例食管鳞状细胞癌患者接受了放射治疗。其中，对40例80岁以上的患者进行了调查。放射治疗的原因分别为单纯高龄22例、IV期疾病13例、合并其他疾病5例。其中，33例患者（83%）接受了60 Gy以上的照射。将接受60 Gy或更高剂量照射的I至III期疾病患者定义为根治性放射治疗组，其他患者定义为姑息性放射治疗组。采用Kaplan-Meier法确定精算生存率。
根治性放射治疗组（n = 25）的5年疾病特异性生存率为34%，有3例并发死亡。姑息性放射治疗组（n = 15）的患者，包括13例IV期患者和2例放弃治疗的患者，均无存活超过2年者。两组均未观察到严重的放射损伤。局部反应完全缓解的病例5年疾病特异性生存率为64%，部分缓解和无变化的病例为8%（p < 0.01）。肿瘤长度小于5 cm的患者5年疾病特异性生存率为64%，肿瘤长度大于5 cm的患者为8%（p < 0.001）。在性别和肿瘤部位方面未发现显著的生存差异。根据影像学表现，浅表扩散型和息肉型肿瘤患者的预后优于溃疡型和环周型肿瘤患者。
放射治疗对于80岁以上的食管癌患者是一种安全有效的治疗方法。
