Proton beam therapy is a safe and effective treatment in elderly patients with esophageal squamous cell carcinoma.
Aged
aged 80 and over
esophageal neoplasms
proton therapy
Journal
Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
27
03
2020
revised:
12
05
2020
accepted:
14
05
2020
pubmed:
9
6
2020
medline:
13
8
2021
entrez:
9
6
2020
Statut:
ppublish
Résumé
There are many elderly patients with esophageal squamous cell carcinoma (ESCC). However, there are currently few articles regarding the clinical outcome following proton beam therapy in these patients. The purpose of this study was to evaluate the clinical results of proton beam therapy in elderly patients with ESCC. Between January 2009 and December 2013, patients aged ≥75 years who underwent proton beam therapy were examined using multi-institutional data from Japan. There were 38 inoperable patients (70.4%) and 16 operable patients (29.6%). More than 40% of patients had stage III/IV ESCC. The five-year overall and cancer-specific survival rates were 56.2% and 71.7%, respectively. Performance status was the only factor that significantly influenced overall survival during the multivariate analysis. The five-year local control rate was 61.8%, and local recurrence occurred within 13 months in 82.4% of patients,. There was no grade 3 or higher toxicity, excluding three patients with grade 3 esophageal ulcers. In conclusion, proton beam therapy may become an alternative treatment with lower toxicity in elderly patients with ESCC, compared to surgery or conventional X-ray radiotherapy. This includes inoperable patients. SIGNIFICANT FINDINGS OF THE STUDY: Proton beam therapy was a safe and effective treatment for elderly patients with esophageal squamous cell carcinoma (ESCC) including inoperable patients. Proton beam therapy may be a safer treatment choice for elderly patients with ESCC compared to conventional X-ray radiotherapy.
Sections du résumé
BACKGROUND
There are many elderly patients with esophageal squamous cell carcinoma (ESCC). However, there are currently few articles regarding the clinical outcome following proton beam therapy in these patients. The purpose of this study was to evaluate the clinical results of proton beam therapy in elderly patients with ESCC.
METHODS
Between January 2009 and December 2013, patients aged ≥75 years who underwent proton beam therapy were examined using multi-institutional data from Japan.
RESULTS
There were 38 inoperable patients (70.4%) and 16 operable patients (29.6%). More than 40% of patients had stage III/IV ESCC. The five-year overall and cancer-specific survival rates were 56.2% and 71.7%, respectively. Performance status was the only factor that significantly influenced overall survival during the multivariate analysis. The five-year local control rate was 61.8%, and local recurrence occurred within 13 months in 82.4% of patients,. There was no grade 3 or higher toxicity, excluding three patients with grade 3 esophageal ulcers.
CONCLUSIONS
In conclusion, proton beam therapy may become an alternative treatment with lower toxicity in elderly patients with ESCC, compared to surgery or conventional X-ray radiotherapy. This includes inoperable patients.
KEY POINTS
SIGNIFICANT FINDINGS OF THE STUDY: Proton beam therapy was a safe and effective treatment for elderly patients with esophageal squamous cell carcinoma (ESCC) including inoperable patients.
WHAT THIS STUDY ADDS
Proton beam therapy may be a safer treatment choice for elderly patients with ESCC compared to conventional X-ray radiotherapy.
Identifiants
pubmed: 32510875
doi: 10.1111/1759-7714.13524
pmc: PMC7396394
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2170-2177Informations de copyright
© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
Références
Medicine (Baltimore). 2017 Sep;96(35):e7920
pubmed: 28858114
J Geriatr Oncol. 2020 May;11(4):675-679
pubmed: 31471169
Esophagus. 2020 Jul;17(3):223-229
pubmed: 32088786
Int J Radiat Oncol Biol Phys. 2006 Mar 15;64(4):1112-21
pubmed: 16376491
Esophagus. 2017;14(3):189-214
pubmed: 28725168
J Clin Oncol. 2007 Mar 10;25(8):953-64
pubmed: 17350944
Front Oncol. 2020 Mar 12;10:153
pubmed: 32226770
Expert Opin Pharmacother. 2017 Jul;18(10):1001-1010
pubmed: 28540761
Eur J Surg Oncol. 2017 Apr;43(4):788-795
pubmed: 28131669
Radiat Oncol. 2018 Feb 9;13(1):23
pubmed: 29426342
J Clin Oncol. 2020 May 10;38(14):1569-1579
pubmed: 32160096
Oncotarget. 2017 Sep 15;8(47):83022-83029
pubmed: 29137320
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
Lancet Oncol. 2007 Mar;8(3):226-34
pubmed: 17329193
Dis Esophagus. 2013 Apr;26(3):250-62
pubmed: 22591068
J Gastrointest Oncol. 2015 Oct;6(5):516-23
pubmed: 26487946
Int J Radiat Oncol Biol Phys. 2017 Nov 1;99(3):667-676
pubmed: 29280461
In Vivo. 2019 May-Jun;33(3):925-932
pubmed: 31028218
Anticancer Res. 2019 Aug;39(8):4279-4283
pubmed: 31366518
Am Fam Physician. 2017 Jan 1;95(1):22-28
pubmed: 28075104
JAMA. 1999 May 5;281(17):1623-7
pubmed: 10235156
J Geriatr Oncol. 2018 Nov;9(6):560-568
pubmed: 29680585
Oncotarget. 2017 Dec 4;8(67):112094-112102
pubmed: 29340114
Lancet Oncol. 2015 Sep;16(9):1090-1098
pubmed: 26254683
Ann Surg. 2020 Jul;272(1):118-124
pubmed: 30720501
Clin Transl Radiat Oncol. 2019 Apr 24;17:17-23
pubmed: 31080898
Ann Surg Oncol. 2012 Jan;19(1):68-74
pubmed: 21879261