Prospective trial of radiotherapy for patients 80 years of age or older with squamous cell carcinoma of the thoracic esophagus.

Abstract

PURPOSE:

To assess the safety and efficacy of external beam radiotherapy for elderly patients with esophageal cancer.

METHODS AND MATERIALS:

A trial testing external beam radiotherapy (66 Gy within 6.5 weeks) as a single-modality treatment was performed for biopsy-proven squamous cell carcinoma of the thoracic esophagus clinically staged as Stage I and IIA (T1-T3N0M0, International Union Against Cancer, 1987) in patients aged > or =80 years.

RESULTS:

From January 1999 through December 2002, 51 evaluable patients (35 men and 16 women) with a median age of 83 years (range, 80-91 years) were enrolled from 22 institutions. Of the 51 patients, 18 (35%) had Stage T1 and 33 (65%) had Stage T2-T3 disease. Radiotherapy could be completed in 47 patients (92%) within 43-58 days (median, 49). The actuarial incidence of Grade 3 or worse cardiopulmonary complications at 3 years was 26%, with 3 early deaths, and correlated significantly with the size of the anteroposterior radiotherapy portals. The median survival time and overall survival rate at 3 years was 30 months and 39% (95% confidence interval, 25-52%), respectively.

CONCLUSION:

The results of high-dose radiotherapy in octogenarians are comparable to those in younger patients, but meticulous treatment planning and quality control is required.

• Authors: Mitsuhiko Kawashima, Yoshikazu Kagami, Takafumi Toita, Takashi Uno, Masato Sugiyama, Yoichirio Tamura, Saeko Hirota, Nobukazu Fuwa, Mitsumasa Hashimoto, Hiroshi Yoshida, Naoto Shikama, Masaaki Kataoka, Keizo Akuta, Kinro Sasaki, Tetsuro Tamamoto, Kenji Nemoto, Hisao Ito, Hoichi Kato, Shogo Yamada, Hiroshi Ikeda
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 64 Issue 4 Pg. 1112-21 (Mar 15 2006) ISSN: 0360-3016 [Print] United States
• PMID: 16376491 (Publication Type: Journal Article, Multicenter Study)

Topics

• Aged, 80 and over
• Carcinoma, Squamous Cell (mortality, pathology, radiotherapy)
• Cause of Death
• Esophageal Neoplasms (mortality, pathology, radiotherapy)
• Female
• Humans
• Male
• Multivariate Analysis
• Neoplasm Staging
• Proportional Hazards Models
• Prospective Studies
• Radiotherapy (adverse effects)
• Radiotherapy Dosage
• Treatment Failure