Chemoradiotherapy and radiotherapy alone in patients with esophageal cancer aged 80 years or older based on the Comprehensive Registry of Esophageal Cancer in Japan

Abstract

Background

There has been no definitive evidence of chemoradiotherapy being superior to radiotherapy alone in patients aged 80 years or older. The purpose of the present study was to evaluate the results of radiotherapy and chemoradiotherapy in patients aged 80 years or older with esophageal cancer in the Japanese Nationwide Cancer Database.

Methods

A total of 358 patients aged 80 years or older who were treated with radiotherapy alone or with chemoradiotherapy for esophageal cancer between 2009 and 2011 were enrolled.

Results

The 5-year overall survival (OS) rates in patients with cStages 0–I, II, III and IV were 40.9%, 24.7%, 12.2% and 4.9%, respectively. The 5-year cause-specific survival (CSS) rates in patients aged 80 years or older with cStages 0–I, cStage II, cStage III and cStage IV were 73.5%, 41.4%, 25.3% and 7.4%, respectively. In patients treated with radiotherapy alone, the 5-year OS rates for patients with cStages 0–I, II, III and IV were 36.5%, 12.0%, 5.4% and 0%, respectively. In patients treated with chemoradiotherapy, the 5-year OS rates for patients with cStages 0–I, II, III and IV were 45.0%, 36.1%, 16.4% and 7.1%, respectively. In multivariate analysis, chemoradiotherapy, early stage and squamous cell carcinoma were significantly favorable prognostic factors for OS in patients aged 80 years or older (p < 0.001, p < 0.001 and p = 0.0323, respectively). We were unable to evaluate toxicities, because of lack of information in the registry.

Conclusion

Concurrent chemotherapy with radiotherapy for esophageal cancer in patients aged 80 years or older is a significantly favorable prognostic factor for OS. However, chemoradiotherapy should be carefully selected in elderly patients.

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Acknowledgements

The authors thank all of the institutions that contributed to the Comprehensive Registry of Esophageal Cancer in Japan by the Japan Esophageal Society for 2015–2017 surveys.

Funding

None.

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Authors

Contributions

Planning of the study and writing: KJ, TU, KN. Data analysis: KJ, HN. Discussion and advice: YD, YT, HM.

Corresponding author

Correspondence to Keiichi Jingu.

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Ethical Statement

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964 and later versions.

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All authors declare that they have no potential conflicts of interest in this manuscript.

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Jingu, K., Numasaki, H., Toh, Y. et al. Chemoradiotherapy and radiotherapy alone in patients with esophageal cancer aged 80 years or older based on the Comprehensive Registry of Esophageal Cancer in Japan. Esophagus 17, 223–229 (2020). https://doi.org/10.1007/s10388-020-00725-w

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Keywords

  • Esophageal cancer
  • Radiotherapy
  • Chemoradiotherapy
  • Elderly patients
  • Nationwide survey