Expert consensus on radiotherapy for elderly patients with esophageal cancer in China (2024 edition)

China exhibits a high incidence of esophageal cancer. In the context of rapid population aging, esophageal cancer has become a significant threat to the health of Chinese elderly population. Currently, there is a lack of a clear definition or assessment method for esophageal cancer in elderly patients, and this population is frequently excluded in clinical trials. Consequently, high-level evidence and global consensus guidelines for the treatment of this population are unavailable. Since elderly patients with esophageal cancer cannot tolerate surgery and intensive chemotherapy, radiotherapy plays a vital role in their treatment. Based on recent research data on esophageal cancer in elderly patients, the expert consensus on radiotherapy for esophageal cancer in elderly patients in China was jointly developed by experts from the following organizations: Radiation Oncology Physician Branch, Chinese Medical Doctor Association; Radiation Oncology Branch, Chinese Medical Association; Professional Committee of Radiation Oncology, China Anti-Cancer Association; Expert Committee of Esophageal Cancer, Chinese Cancer Radiotherapy Alliance; Radiotherapy Sub-Committee, Professional Committee of Elderly Oncology, Gerontological Society of China. This consensus defines esophageal cancer in elderly patients, emphasizes the importance of nutritional assessment and intervention, and elaborates on the mode of radiotherapy alone and radiotherapy-based combined modality therapy mode. Moreover, this consensus organizes radiotherapy technology, radiation dose, and safety management, aiming to provide a foundational guide for clinical practice targeting esophageal cancer in elderly patients.