Chemoradiotherapy for Elderly Patients—Esophageal Cancer

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  • Kato Ken
    Gastrointestinal Oncology Division, National Cancer Center Hospital

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  • 高齢者に対する放射線・化学療法—食道—
  • 高齢者に対する放射線・化学療法 : 食道
  • コウレイシャ ニ タイスル ホウシャセン ・ カガク リョウホウ : ショクドウ
  • Chemoradiotherapy for Elderly Patients^|^mdash;Esophageal Cancer

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Abstract

Esophageal cancer patients are relatively high in age, with most being 70 and over. 5-FU and cisplatin constitute the standard chemoradiotherapy regimen for esophageal cancer. In two retrospective analyses of esophageal cancer patients using 5-FU/CDDP combined with radiation, elderly patients showed a tendency toward poor compliance and higher toxicity than younger patients. The complete response rate of elderly patients was approximately 50-60% and the 2-year survival was 40-50%, which seemed to be lower response and survival compared to younger patients. This may reflect more morbidities and hidden organ dysfunctions in elderly patients. Therefore new strategies are needed for elderly patients to improve toxicities and compliance. A phase II study of weekly administration of docetaxel concurrent with 60Gy radiation was held for elderly esophageal cancer patients was held. The 1-year progression-free survival and 1-year overall survival rate were 66.7% and 85.7%, respectively. Grade 3 esophagitis was observed in 31% of the patients. As observation time was relatively short, more observation is needed to evaluate the efficacy. Other drugs such as paclitaxel or oxaliplatin also have potential as treatment for elderly patients. Evidence in prospective clinical trials is needed.

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