Prognosis in patients over the age of 80 years with esophageal cancer treated by different radiotherapy doses(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2020年第8期
- Page:
- 977-981
- Research Field:
- 医学放射物理
- Publishing date:
Info
- Title:
- Prognosis in patients over the age of 80 years with esophageal cancer treated by different radiotherapy doses
- Author(s):
- LIU Wei1; XUE Xudong1; LUO Wenguang1; SHEN Qi1; QIAN Liting1; 2; ZHANG Hongyan1
- 1. Department of Radiotherapy, the First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, China 2. Anhui Provincial Cancer Hospital, Hefei 230001, China
- Keywords:
- Keywords: elderly patient esophageal cancer intensity-modulated radiotherapy radiotherapy dose prognosis comorbidity nutritional risk
- PACS:
- R815；R735.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2020.08.007
- Abstract:
- Abstract: Objective To retrospectively evaluate the clinical efficacy, safety and affecting factors of different radiotherapy doses for esophageal cancer in elderly patients aged 80 years or older. Methods The clinical information of 83 elderly patients (≥80 years old) with esophageal cancer who were treated with intensity-modulated radiotherapy from July 2013 to September 2016 were analyzed retrospectively. Kaplan-Meier method was used to calculate overall survival (OS) rates and prognostic-free survival (PFS) rates. Log-rank test was used for univariate prognosis analysis, and Cox regression model for multivariate prognostic analysis. Results The median follow-up time was 37.2 months. The 1-, 2- and 3-year OS rates were 68.7%, 46.7% and 32.1%, respectively and the 1-, 2- and 3-year PFS rates were 61.1%, 40.0% and 24.7%, respectively. The median OS and PFS were 24.1 months and 19.4 months. The results of univariate analysis indicated that radiotherapy?ose (P=0.006 and 0.013), geriatric nutritional risk index (GNRI) (P=0.002 and 0.007) and adult comorbidity evaluation-27 test (ACE-27) score (P=0.018 and 0.040) were the affecting factors for OS and PFS. The results of multivariate analysis showed that GNRI (P=0.007 and 0.019) and radiotherapy?ose (P=0.015 and 0.029) were the independent prognostic factors for OS and PFS. The incidence of adverse reactions above grade 3 in the highest-dose group (≥60 Gy) was 57.1%, which was higher than 25% in low-dose?roup (<54 Gy) (P=0.037) and 26.2% in the relatively higher-dose?roup (54-60 Gy) (P=0.016). Conclusion Intensity-modulated radiotherapy can be tolerated in esophageal cancer patients over 80 years old. The?utritional?tatus and radiotherapy?ose are the pivotal factors for the prognosis. The radiotherapy?ith the dose of 54-60 Gy can?btain better prognosis and has slighter adverse reactions. Therefore, 54-60 Gy is the preferred radiotherapy dose for elderly patients with esophageal cancer.
Last Update: 2020-08-27