Objective To compare the
prognostic factors and
adverse effects of
elderly patients with
esophageal cancer between
radiotherapy alone and
concurrent chemoradiotherapy.
Methods A total of 479
patients with
esophageal squamous cell carcinoma aged 70 years or older were analyzed retrospectively at our institute, from January 2008 to December 2017. The
patients were divided into
radiotherapy alone group ( 359 cases ) and
concurrent chemoradiotherapy group ( 120 cases ) . After
Propensity Score Matching ( PSM) , data from matched
patients with 102 cases in each group was analyzed. The overall
survival (OS) rates, the
prognostic factors and
adverse effects were assessed. Results The 1, 3, 5-year of OS in
radiotherapy alone group after PSM were 77. 4%, 40. 1%, 22. 7%, respectively, and median overall
survival time (mOS) was 26. 9 months (95% CI18. 7 - 35. 2 months). The
chemoradiotherapy group after PSM were 79. 5%, 47. 6%, 35. 7% and 35. 6 months (95% CI23. 2-48.0 months), respectively, while there was no significant difference between the groups (P >0. 05). Subgroup
analysis showed that the 1, 3, 5-year of OS and mOS of the
patients aged 70 -75 years in
radiotherapy alone group were 79. 4%, 41. 0%, 26. 2% and 29. 2 months, respectively. The
patients aged 70-75 years in
chemoradiotherapy group were 86. 5%, 56. 1%, 47. 6% and 48. 9 months, respectively. There was statistically significance between the groups after PSM(χ2 =4. 746, P<0. 05). The univariate prognostic
analysis showed that the age, T stage, N stage, clinical stage, short-term
efficacy and performance status were influencing factors for OS (χ2 =6. 714-42. 900, P<0. 05). The clinical stage and short-term
efficacy were independent
prognostic factors for OS (χ2 =5. 007 -9. 181, P<0. 05). In addition , the
risk of non-
tumor related
death of the
patients aged 75 years or older in the
chemoradiotherapy group was higher than those in the
radiotherapy alone group(χ2 =5. 630, P<0. 05). The
prevalence of toxicities (≥grade 3) including
bone marrow suppression,
radiation esophagitis and
radiation pneumonia in the
chemoradiotherapy group were higher than that in the
radiotherapy alone group (χ2 =4. 701 -28. 318, P<0. 05). Conclusions
Concurrent chemoradiotherapy, compared with
radiotherapy alone, may improve the
prognosis of
patients aged 70-75 years with
esophageal squamous cell carcinoma.