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

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

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.

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.

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