Background: Although the prevalence of esophageal cancer increases in elderly patients, its clinical history and outcome after treatment remain poorly described.Methods: Between January 2001 and December 2011, 58 patients (pts) older than 75 years received 3D-conformal radiotherapy (mean dose 51 Gy) in two French cancer centers. 47/58 (82%) patients received concomitant chemotherapy (with CDDP and/or FU regimens) and 8 patients underwent surgery after primary radiochemotherapy (RCT).Results: Median age was 77.9 years and the performance status (PS) was 0 or 1 in 89%. Tumors were mainly adenocarcinoma of lower esophagus or gastroesophageal junction (n = 51, 89%), T3T4 (n = 54, 95%), and N1 (n = 44, 77%). The mean follow-up was 21.9 months. In the overall population, the median progression-free survival was 9.6 months and median overall survival (OS) was 14.5 months. Using univariate analysis, OS was significantly associated with age (p = 0.048), PS (p < 0.001), and surgery (p = 0.035). 35 (60.3%) and 18 patients (31%) experienced grade 1–2 or 3–4 toxicity, respectively (CTCAE v4.0).Conclusion: Radiochemotherapy in elderly patients is a feasible treatment and its outcome is close to younger patient’s outcome published in the literature. Surgical resection, after comprehensive geriatric assessment, should be recommended as the standard treatment for adenocarcinoma of lower esophagus or gastroesophageal junction in elderly patients with good PS and low co-morbidity profile, as it is in younger patients.
six cycles. 39% (24/61) of patients inoperable after 3 cycles changed chemotherapy regimens; 42% (10/24) of the latter switched to weekly paclitaxel, 21% (5/24) to bevacizumabbased regimen, and 13% (3/24) to carboplatin + liposomal doxorubcin (Caelyx ® ). 25% (6/24) had palliative aromatase inhibitors or stopped chemo entirely. Of those who had their chemotherapy changed, only 1 patient in bevacizumab group (4%) achieved optimal debulking. Median overall suvival(OS) in those who switched regimen was 17.47 vs 37.40 months in those who did not, p=0.79. Conclusion* Switching chemotherapy regimen in previously inoperable patients did not lead to improved OS. This may reflect the poor prognosis conferred by inadequate response to platinum-based therapy, and needs further evaluation. Though the numbers in each group were small, a change to bevacizumab-based regimen did not appear to improve outcomes. The ICON 8b study will provide further information regarding bevacizumab's role in the neoadjuvant setting.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.