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. 2008 Nov 18;99(10):1586-92.
doi: 10.1038/sj.bjc.6604749. Epub 2008 Oct 28.

Safety and outcome of definitive chemoradiotherapy in elderly patients with oesophageal cancer

D Tougeron  1 , F Di Fiore, S Thureau, N Berbera, I Iwanicki-Caron, H Hamidou, B Paillot, P Michel
Affiliations

Safety and outcome of definitive chemoradiotherapy in elderly patients with oesophageal cancer

D Tougeron et al. Br J Cancer. .

Abstract

Little is known about chemoradiotherapy (CRT) in elderly patients with a locally advanced oesophageal cancer (OC). The aim of our study was to evaluate the tolerance and the outcome of elderly patients older than 70 years treated with CRT for a non-metastatic OC. Chemoradiotherapy was based on radiotherapy combined with a cisplatin-based chemotherapy. Clinical complete response (CCR) to CRT was evaluated on upper digestive endoscopy and computed tomography scan 6-8 weeks after CRT completion. One hundred and nine consecutive patients were included. A CCR was observed in 63 patients (57.8%) and 2-year survival was 35.5%. Adverse events > or =grade 3 were observed in 26 (23.8%) patients. Chemotherapy dose reduction, chemotherapy delays more than 1 week, and treatment discontinuation were observed in 33 (30.3%), 45 (41.3%), and 17 patients (15.6%), respectively. Comorbidity index according to Charlson score was significantly associated with treatment tolerance. In multivariate analysis, a CCR to CRT (P<0.01), a dose of radiotherapy > or =80% (P=0.02), and a Charlson score < or =2 (P=0.046) were identified as independent prognostic factors of overall survival. These results suggest that CRT could be considered as an effective treatment without major toxicity in elderly patients with OC.

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Figures

Figure 1
Figure 1
Overall survival. The median overall survival was 15.2±2.8 months.
Figure 2
Figure 2
Overall survival in responders and non-responders to CRT. The median overall survival was 27.2±5.1 months in responder patients as compared with 6.0±2.5 months in non-responder patients (P<0.01). CCR=clinical complete response; CRT=chemoradiotherapy.
See this image and copyright information in PMC

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