Prognosis of radiotherapy for esophageal cancer in elderly patients exceeding seventy-five years old  

作　　者：Li-Li Hu Feng Rong Lei Liu Ling Zhang Lei-Lei Zhang Qun Yang Zhao-Long Xia Hui Wang 

机构地区：[1]Department of Cancer Center,Lu’an Hospital of Anhui Medical University,Lu’an 237002,Anhui Province,China [2]College of Health and Elderly Care,Anhui Vocational College of City Management,Hefei 230012,Anhui Province,China [3]Department of Oncology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,Anhui Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第12期4636-4649,共14页世界胃肠肿瘤学杂志（英文）

基　　金：Supported by the Science and Technology Program of Lu’an,No.2022 Lakj042.

摘　　要：BACKGROUND Esophageal cancer(EC)often occurs in the elderly,with approximately 33%of patients aged≥75 years at the time of diagnosis.AIM To evaluate the prognostic factors for radiotherapy(RT)in elderly patients with unresectable EC.METHODS We retrospectively analyzed the clinical characteristics,toxic reactions,and survival information of EC patients aged≥75 years who underwent intensity-modulated RT at Lu’an Hospital of Anhui Medical University between January 2016 and September 2023.Kaplan-Meier analysis was used to draw the overall survival(OS)curves,and Cox regression analysis was employed to evaluate the influence of various clinical factors on the prognosis.RESULTS A total of 139 patients were enrolled.The median follow-up time was 52.0 months.The median OS was 20.0 months.The 1-year,2-year,3-year,and 5-year OS rates were 69.8%,38.7%,28.2%,and 17.5%,respectively.Univariate analysis showed that age,radiation dose,and chemotherapy had no significant impact on prognosis.Multivariate analysis indicated that clinical stage[Ⅲ-Ⅳa vsⅠ-Ⅱ,hazard ratio(HR)=2.421,95%confidence interval(CI):1.242-4.718,P=0.009;IVb vsⅠ-Ⅱ,HR=4.222,95%CI:1.888-9.438,P<0.001),Charlson comorbidity index(CCI)(0 vs≥1,HR=1.539,95%CI:1.015-2.332,P=0.042),and nutritional risk screening 2002(NRS2002)(<3 vs≥3,HR=2.491,95%CI:1.601-3.875,P<0.001)were independent prognostic factors for OS.CONCLUSION Our results suggest that CCI and NRS2002 were independent prognostic factors of OS for unresectable elderly EC patients undergoing RT.For elderly patients with EC,full attention should be given to biological age-related indicators,such as comorbidities and nutrition,when formulating treatment protocols.These factors should be considered in future clinical practice.

关 键 词：Elderly patient Esophageal cancer RADIOTHERAPY PROGNOSIS COMORBIDITY Nutritional risk 

分 类 号：R735.1[医药卫生—肿瘤]