Feasibility and Efficacy of Concurrent Chemoradiotherapy in Elderly Patients with Esophageal Squamous Cell Carcinoma: a Respective Study of 116 Cases from a Single Institution

Background: To evaluate the safety and efficacy of combined chemoradiotherapy or radiotherapy alone inelderly patients with esophageal carcinoma to identify the best method of treatment. Materials and
Methods: Onehundred and sixteen patients with esophageal carcinoma aged 70 and older who received definitive radiotherapyor chemoradiotherapy entered the study. Overall survival (OS), disease-free survival (DFS) and treatmentrelatedtoxicities were assessed.
Results: The median OS of the overall population was 17.9 months. For patientstreated with cCRT, sCRT and radiotherapy alone, the median OS was 22.3 months, 18.0 months and 12.4 monthsrespectively(P=0.044). Median OS for patients treated with radiotherapy dose ≥60Gy and <60Gy was 20.2 monthsand 10.9 months respectively (p=0.017). By univariate analysis, Chemoradiotherapy (include cCRT and sCRT)and radiotherapy dose ≥60Gy were found to achieve higher survival rates compared with radiotherapy aloneand radiotherapy dose <60Gy (P=0.015, P=0.017). By multivariate analysis, chemoradiotherapy (HR=1.645,P=0.022) and radiotherapy dose ≥60Gy (HR=1.642, P=0.025) were identified as independent prognostic factorsof OS.
Conclusions: Definitive concurrent chemoradiotherapy could be considered as a feasible and effectivetreatment in esophageal carcinoma patients aged 70 and older. Radiotherapy dose 60Gy is an effective treatmentoption compared with standard dose radiotherapy, while higher doses are not beneficial to improve survival.