Chemoradiotherapy feasible for elderly patients with esophageal cancer


NEW YORK (Reuters Health), Dec 18 - Definitive chemoradiotherapy is an effective treatment that can be dispensed with no significant toxicity in elderly patients with locally advanced esophageal cancer, according to a 13-year study conducted at Rouen University Hospital in France.

The study included all consecutive patients older than 70 years with nonmetastatic esophageal cancer who were treated with radiation combined with cisplatin-based chemotherapy between 1994 and 2007.

Among the 109 patients analyzed, 63 (57.8%) experienced a complete clinical response, and 26 (23.8%) had no recurrence after a median follow-up of 20.5 months, Dr. David Tougeron and associates report in the November 11 issue of the British Journal of Cancer.

The median overall survival was 15.2 months, median disease-free survival was 8.3 months, and the two-year survival rate was 35.5%.

"Our results showed that chemoradiotherapy in elderly patients produced a similar response rate and overall survival as usually reported in younger patients treated with the same regimen," the authors maintain.

Although the planned protocol was given in less than half of the patients, and more than half required dose adjustments, there were only three patients with grade 4 toxicity and two treatment-related deaths. High scores on the Charlson comorbidity index were significantly associated with treatment intolerance.

In multivariate analysis, a clinical complete response, receipt of at least 80% of planned dose of radiotherapy, and a Charlson score of no greater than 2 were independent predictors of overall survival.

"In conclusion," Tougeron's group states, "definitive chemoradiotherapy could be considered as an effective treatment with no significant toxicity in elderly patients with esophageal cancer."

Br J Cancer 2008;99:1586-1592.

Last Updated: 2008-12-18 8:00:10 -0400 (Reuters Health)

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