PDF(Pubmed)
Abstract：
Outcomes for patients receiving radiotherapy (RT) for non-metastatic esophageal cancer at a single institution were assessed, as well as the impact of factors including age and intensity modulated RT (IMRT) planning on patient outcomes. A retrospective cohort of patients treated with RT for stage I-III esophageal cancer between 2010 and 2018 was identified. Among 248 identified patients, 28 % identified as older (≥75 years of age). Other than histology, there were no other statistically significant differences in patient and tumour characteristics between the younger and older populations. Treatments varied between the two age groups, with significantly less older patients completing trimodality treatments (17 % vs 58 %). Median overall survival (M-OS) and progression-free survival (M-PFS) were 20 months and 12 months for all patients and 40 months and 26 months for trimodality patients, respectively. In the older patients, the M-OS improved from 13 months for all to 34 months for trimodality patients; and M-PFS from 10 months to 16 months. On multivariate analysis, the use of trimodality therapy showed improved OS (HR 0.26, p < 0.001). In the non-surgical older patient group, significantly better survival was seen in patients who had a heart V30Gy under 46 %. There was no significant difference in M-OS in patients planned with IMRT compared with 3D-conformal RT. Clinical outcomes in the treatment of esophageal cancer vary significantly by treatment approach, with the most favourable results in those receiving trimodality therapy. Among older patients deemed fit after assessment by the multidisciplinary team for trimodality treatments, the M-OS is comparable to the younger patient group.
摘要：
评估了在单个机构接受非转移性食管癌放疗（RT）的患者的预后，以及年龄和调强放疗（IMRT）计划等因素对患者预后的影响。确定了2010年至2018年间接受RT治疗的I-III期食管癌患者的回顾性队列。在248名确定的患者中，28%被确定为老年人（≥75岁）。除了组织学，年轻人群和老年人群在患者和肿瘤特征方面没有其他统计学显著差异.两个年龄组的治疗方法有所不同，完成三联疗法的老年患者明显较少（17％vs58％）。所有患者的中位总生存期（M-OS）和无进展生存期（M-PFS）分别为20个月和12个月，三联患者分别为40个月和26个月。分别。在老年患者中，对于三模患者,M-OS从13个月提高到34个月;M-PFS从10个月提高到16个月.在多变量分析中，使用三联疗法显示OS改善(HR0.26,p<0.001).在非手术的老年患者组中，心脏V30Gy低于46%的患者的生存率显著提高.与3D适形RT相比，计划进行IMRT的患者的M-OS没有显着差异。食管癌治疗的临床结果因治疗方法而异，在接受三联疗法的患者中效果最好。在经过多学科小组对三联疗法进行评估后认为健康的老年患者中，M-OS与年轻患者组相当.
