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J Korean Soc Ther Radiol Oncol > Volume 27(2); 2009 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2009;27(2): 84-90. doi: https://doi.org/10.3857/jkstro.2009.27.2.84
Concurrent Chemoradiotherapy in Elderly Patients with Locally Advanced Esophageal Carcinoma
Bae Kwon Jung, Ki Mun Kang, Gyeong Won Lee, Jung Hoon Kang, Hoon Gu Kim, Won Seob Lee, Gyu Young Chai
1Department of Radiation Oncology, School of Medicine, Gyeongsang National University, Jinju, Korea.
2Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea.
3Gyeongsang Institute of Health Sciences, Jinju, Korea.
The effect of concurrent chemoradiotherapy was analyzed in elderly patients when used in the treatment of locally advanced esophageal cancer.
The retrospective analysis included 28 elderly patients aged 65 or older, with histopathologically confirmed squamous cell carcinoma of the esophagus, underwent concurrent chemoradiotherapy from January 2001 to July 2007. The squamous cell carcinoma disease stages included 8 patients (28.8%) in stage IIa, 10 patients (35.7%) in stage IIb, and 10 patients (35.7%) in stage III. Fractionated radiotherapy was performed with a 6 MV or 10 MV X-ray for 45~63 Gy (median: 59.4 Gy). Chemotherapy was applied concurrently with the initiation of radiotherapy. A 75 mg/m2 dose of Cisplatin was intravenously administered on day 1. Further, 5-FU 1,000 mg/m2 was continuously administered intravenously from days 1 to 4. This regimen was performed twice at 3-week intervals during radiotherapy. Two cycles of consolidation chemotherapy was performed after radiotherapy.
The follow-up period was 3~72 months (median: 19 months). The treatment responses after concurrent chemoradiotherapy included a complete response in 11 patients (39.3%), a partial response in 14 patients (50.0%), and no response in 3 patients (10.7%). The overall response rate was 89.3% (25 patients). The overall 1-, 2- and 3-year survival rates were 55.9%, 34.6% and 24.2%, respectively. The median survival time was 15 months. Two-year survival rates of patients with a complete response, partial response, and no response were 46.2%, 33.0%, and 0%, respectively. The stage and tumor response after concurrent chemoradiotherapy were statistically significant prognostic factors related with survival. No treatment-related deaths occurred in this study.
Concurrent chemoradiotherapy is a relatively effective treatment without serious complications in elderly patients with locally-advanced esophageal cancer.
Key Words: Elderly patients, Esophageal carcinoma, Concurrent chemoradiotherapy
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