Radiation modality use and cardiopulmonary mortality risk in elderly patients with esophageal cancer

Lin, Steven H.; Zhang, Ning; Godby, Joy; Wang, Jingya; Marsh, G; Liao, Zhongxing; Komaki, Ritsuko; Ho, Linus; Hofstetter, Wayne L.; Swisher, Stephen G.; Mehran, Reza J.; Buchholz, Thomas A.; Elting, Linda S.; Giordano, Sharon H.

doi:10.1002/cncr.29857

Cited by 77 publications

(44 citation statements)

References 26 publications

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“…For the models determined by the SVSS algorithm, patients who received IMRT had significantly reduced risks of pericardial and pleural effusion as well as death before effusion type. This agrees with results from several previous studies which showed that IMRT increased patient survival compared to 3D-CRT [22] [23]. …”

Section: Discussionsupporting

confidence: 93%

Bayesian variable selection for a semi-competing risks model with three hazard functions

Chapple

Vannucci

Thall

et al. 2017

Computational Statistics & Data Analysis

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A variable selection procedure is developed for a semi-competing risks regression model with three hazard functions that uses spike-and-slab priors and stochastic search variable selection algorithms for posterior inference. A rule is devised for choosing the threshold on the marginal posterior probability of variable inclusion based on the Deviance Information Criterion (DIC) that is examined in a simulation study. The method is applied to data from esophageal cancer patients from the MD Anderson Cancer Center, Houston, TX, where the most important covariates are selected in each of the hazards of effusion, death before effusion, and death after effusion. The DIC procedure that is proposed leads to similar selected models regardless of the choices of some of the hyperparameters. The application results show that patients with intensity-modulated radiation therapy have significantly reduced risks of pericardial effusion, pleural effusion, and death before either effusion type.

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Section: Discussionsupporting

confidence: 93%

Bayesian variable selection for a semi-competing risks model with three hazard functions

Chapple

Vannucci

Thall

et al. 2017

Computational Statistics & Data Analysis

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“…However, even RT alone requires special attention in aged patients. The use of intensity-modulated RT was shown to be associated with significantly lower rates of all-cause mortality, cardiac mortality, and other-cause mortality in patients with esophageal cancer (11). Such new technology might be able to reduce deaths from other causes in aged patients.…”

Section: Discussionmentioning

confidence: 99%

Is Concurrent Chemotherapy With Radiotherapy for Esophageal Cancer Beneficial in Patients Aged 80 Years or Older?

et al. 2019

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Background/Aim: To determine whether concurrent chemotherapy with radiotherapy should be performed in elderly patients with esophageal cancer. Patients and Methods: A total of 185 patients aged 80 years or older who were treated with definitive radiotherapy alone or combined with chemoradiotherapy for esophageal cancer at seven institutions were enrolled. In order to compare survival rates of patients treated with chemoradiotherapy with those of patients treated with radiotherapy alone, propensity score matching was performed to homogenize the two populations. Results: For the whole patient cohort, the 3-year overall survival (OS) rate was 52.6% and the median survival was 42.5 months. After propensity score matching, the 3-year OS rate for the chemoradiotherapy group was not significantly better than that for the group treated with radiotherapy alone (53.7% vs. 59.9%, p=0.876). Conclusion: Concurrent chemotherapy with radiotherapy for esophageal cancer in patients aged 80 years or older did not have significant OS benefit over radiotherapy alone. Esophageal cancer is the fifth most common cause of cancerrelated death worldwide for men and the eighth most common cause of cancer-related death worldwide for women (1). Since the Radiation Therapy Oncology Group (RTOG) 85-01 trial showed that the outcome of definitive chemoradiotherapy was significantly better than that of radiotherapy alone for patients with esophageal cancer (2), concurrent chemoradiotherapy has been a standard treatment for esophageal cancer. However, most patients aged 80 years or older are unlikely to be able to tolerate chemotherapy. There are about 4,000 patients aged 80 years or older with esophageal cancer in Japan every year. Miyata et al. reported that elderly patients aged 80 years or older who underwent surgery for esophageal cancer had a poorer prognosis than did younger patients because a smaller percentage of elderly patients received neoadjuvant therapy (3). They concluded that aggressive treatment may be recommended for elderly patients. Based on data from Surveillance, Epidemiology, and End Results (SEER), patients aged 80 years or older with esophageal cancer benefit from radiotherapy alone compared to no radiotherapy if the cancer is in a localized/regional stage (4). The results of analysis of data in a Japanese nationwide database showed that radiotherapy alone tended to be performed for elderly patients (5). There is no definitive evidence of a beneficial effect of concurrent chemotherapy with radiotherapy for elderly patients with esophageal cancer. The purpose of the present study was to determine whether concurrent chemotherapy with radiotherapy rather than radiotherapy alone should be administered to patients with esophageal cancer aged 80 years or older. Patients and Methods Patient eligibility. The eligibility criteria included i) histopathologically proven esophageal cancer; ii) clinical stage T1-4; N0-1; M0/M1 lym [International Union Against Cancer (UICC) 2002)] (6); iii) 80 or more years of age; iv) no history of rad...

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“…Further support for IMRT in reducing toxicities over 3DCRT comes from an analysis of two large cancer registries, encompassing over 2500 elderly patients [32]. Of note, IMRT had increased over 10-fold from 2002 to 2009, with a corresponding decrease in 3DCRT.…”

Section: Intensity-modulated Radiotherapymentioning

confidence: 99%

Advances in Radiotherapy Management of Esophageal Cancer

Verma

Moreno

Lin

2016

JCM

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Radiation therapy (RT) as part of multidisciplinary oncologic care has been marked by profound advancements over the past decades. As part of multimodality therapy for esophageal cancer (EC), a prime goal of RT is to minimize not only treatment toxicities, but also postoperative complications and hospitalizations. Herein, discussion commences with the historical approaches to treating EC, including seminal trials supporting multimodality therapy. Subsequently, the impact of RT techniques, including three-dimensional conformal RT, intensity-modulated RT, and proton beam therapy, is examined through available data. We further discuss existing data and the potential for further development in the future, with an appraisal of the future outlook of technological advancements of RT for EC.

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Radiation modality use and cardiopulmonary mortality risk in elderly patients with esophageal cancer

Cited by 77 publications

References 26 publications

Bayesian variable selection for a semi-competing risks model with three hazard functions

Bayesian variable selection for a semi-competing risks model with three hazard functions

Is Concurrent Chemotherapy With Radiotherapy for Esophageal Cancer Beneficial in Patients Aged 80 Years or Older?

Advances in Radiotherapy Management of Esophageal Cancer

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