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

IF 2.5 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Li-Li Hu, Feng Rong, Lei Liu, Ling Zhang, Lei-Lei Zhang, Qun Yang, Zhao-Long Xia, Hui Wang
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引用次数: 0

Abstract

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 vs I-II, hazard ratio (HR) = 2.421, 95% confidence interval (CI): 1.242-4.718, P = 0.009; IVb vs I-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.

七十五岁以上老年食管癌放疗的预后。
背景:食管癌(EC)常见于老年人,约33%的患者在诊断时年龄≥75岁。目的:探讨影响老年不可切除癌放疗预后的因素。方法:回顾性分析2016年1月至2023年9月在安徽医科大学六安医院接受调强放疗的≥75岁EC患者的临床特征、毒性反应及生存信息。采用Kaplan-Meier分析绘制总生存(OS)曲线,采用Cox回归分析评价各种临床因素对预后的影响。结果:共纳入139例患者。中位随访时间为52.0个月。中位OS为20.0个月。1年、2年、3年、5年生存率分别为69.8%、38.7%、28.2%、17.5%。单因素分析显示,年龄、放疗剂量和化疗对预后无显著影响。多因素分析显示临床分期[III-IVa vs I-II],危险比(HR) = 2.421, 95%可信区间(CI): 1.242 ~ 4.718, P = 0.009;IVb vs I-II, HR = 4.222, 95%CI: 1.888 ~ 9.438, P < 0.001)、Charlson共病指数(CCI) (0 vs≥1,HR = 1.539, 95%CI: 1.015 ~ 2.332, P = 0.042)和营养风险筛查2002 (NRS2002) (< 3 vs≥3,HR = 2.491, 95%CI: 1.601 ~ 3.875, P < 0.001)是OS的独立预后因素。结论:CCI和NRS2002是不能切除的老年EC行rt患者OS的独立预后因素。对于老年EC患者,在制定治疗方案时应充分重视与年龄相关的生物学指标,如合并症和营养。这些因素应在今后的临床实践中加以考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Gastrointestinal Oncology
World Journal of Gastrointestinal Oncology Medicine-Gastroenterology
CiteScore
4.20
自引率
3.30%
发文量
1082
期刊介绍: The World Journal of Gastrointestinal Oncology (WJGO) is a leading academic journal devoted to reporting the latest, cutting-edge research progress and findings of basic research and clinical practice in the field of gastrointestinal oncology.
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