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Title: Prospective trial of radiotherapy for patients 80 years of age or older with squamous cell carcinoma of the thoracic esophagus

Abstract

Purpose: To assess the safety and efficacy of external beam radiotherapy for elderly patients with esophageal cancer. Methods and Materials: A trial testing external beam radiotherapy (66 Gy within 6.5 weeks) as a single-modality treatment was performed for biopsy-proven squamous cell carcinoma of the thoracic esophagus clinically staged as Stage I and II A (Tz1-Taman, International Union Against Cancer, 1987) in patients aged {>=}80 years. Results: From January 1999 through December 2002, 51 evaluable patients (35 men and 16 women) with a median age of 83 years (range, 80-91 years) were enrolled from 22 institutions. Of the 51 patients, 18 (35%) had Stage Tz1 and 33 (65%) had Stage Tz2-T disease. Radiotherapy could be completed in 47 patients (92%) within 43-58 days (median, 49). The actuarial incidence of Grade 3 or worse cardiopulmonary complications at 3 years was 26%, with 3 early deaths, and correlated significantly with the size of the anteroposterior radiotherapy portals. The median survival time and overall survival rate at 3 years was 30 months and 39% (95% confidence interval, 25-52%), respectively. Conclusion: The results of high-dose radiotherapy in octogenarians are comparable to those in younger patients, but meticulous treatment planning and quality control is required.

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10];  [11];  [12];  [13];  [14];  [15];  [16];  [4];  [17];  [16];  [2]
  1. Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa (Japan). E-mail: mkawashi@east.ncc.go.jp
  2. Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)
  3. Department of Radiology, University of the Ryukyus Graduate School of Medical Science, Okinawa (Japan)
  4. Department of Radiology, Chiba University School of Medicine, Chiba (Japan)
  5. Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama (Japan)
  6. Department of Surgery, Kasumigaura Medical Center, Tsuchiura (Japan)
  7. Department of Radiology, Hyogo Medical Center for Adults, Akashi (Japan)
  8. Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan)
  9. Department of Surgery, Social Insurance Saitama Hospital, Saitama (Japan)
  10. Department of Radiology, Asahikawa Medical College, Asahikawa (Japan)
  11. Department of Radiology, Shinshu University School of Medicine, Matsumoto (Japan)
  12. Department of Radiation Oncology, Shikoku Cancer Center, Matsuyama (Japan)
  13. Department of Radiology, Ohtsu Red Cross Hospital, Ohtsu (Japan)
  14. Department of Surgery I, Dokkyo University School of Medicine, Shimotsuga (Japan)
  15. Department of Radiation Oncology, Nara Medical University, Nara (Japan)
  16. Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai (Japan)
  17. Division of Esophageal Surgery, National Cancer Center Hospital, Tokyo (Japan)
Publication Date:
OSTI Identifier:
20793390
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2005.09.027; PII: S0360-3016(05)02718-5; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BEAMS; BIOPSY; CARCINOMAS; DEATH; ESOPHAGUS; PATIENTS; QUALITY CONTROL; RADIOTHERAPY; SURVIVAL TIME

Citation Formats

Kawashima, Mitsuhiko, Kagami, Yoshikazu, Toita, Takafumi, Uno, Takashi, Sugiyama, Masato, Tamura, Yoichirio, Hirota, Saeko, Fuwa, Nobukazu, Hashimoto, Mitsumasa, Yoshida, Hiroshi, Shikama, Naoto, Kataoka, Masaaki, Akuta, Keizo, Sasaki, Kinro, Tamamoto, Tetsuro, Nemoto, Kenji, Ito, Hisao, Kato, Hoichi, Yamada, Shogo, and Ikeda, Hiroshi. Prospective trial of radiotherapy for patients 80 years of age or older with squamous cell carcinoma of the thoracic esophagus. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Kawashima, Mitsuhiko, Kagami, Yoshikazu, Toita, Takafumi, Uno, Takashi, Sugiyama, Masato, Tamura, Yoichirio, Hirota, Saeko, Fuwa, Nobukazu, Hashimoto, Mitsumasa, Yoshida, Hiroshi, Shikama, Naoto, Kataoka, Masaaki, Akuta, Keizo, Sasaki, Kinro, Tamamoto, Tetsuro, Nemoto, Kenji, Ito, Hisao, Kato, Hoichi, Yamada, Shogo, & Ikeda, Hiroshi. Prospective trial of radiotherapy for patients 80 years of age or older with squamous cell carcinoma of the thoracic esophagus. United States. doi:10.1016/J.IJROBP.2005.0.
Kawashima, Mitsuhiko, Kagami, Yoshikazu, Toita, Takafumi, Uno, Takashi, Sugiyama, Masato, Tamura, Yoichirio, Hirota, Saeko, Fuwa, Nobukazu, Hashimoto, Mitsumasa, Yoshida, Hiroshi, Shikama, Naoto, Kataoka, Masaaki, Akuta, Keizo, Sasaki, Kinro, Tamamoto, Tetsuro, Nemoto, Kenji, Ito, Hisao, Kato, Hoichi, Yamada, Shogo, and Ikeda, Hiroshi. Wed . "Prospective trial of radiotherapy for patients 80 years of age or older with squamous cell carcinoma of the thoracic esophagus". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20793390,
title = {Prospective trial of radiotherapy for patients 80 years of age or older with squamous cell carcinoma of the thoracic esophagus},
author = {Kawashima, Mitsuhiko and Kagami, Yoshikazu and Toita, Takafumi and Uno, Takashi and Sugiyama, Masato and Tamura, Yoichirio and Hirota, Saeko and Fuwa, Nobukazu and Hashimoto, Mitsumasa and Yoshida, Hiroshi and Shikama, Naoto and Kataoka, Masaaki and Akuta, Keizo and Sasaki, Kinro and Tamamoto, Tetsuro and Nemoto, Kenji and Ito, Hisao and Kato, Hoichi and Yamada, Shogo and Ikeda, Hiroshi},
abstractNote = {Purpose: To assess the safety and efficacy of external beam radiotherapy for elderly patients with esophageal cancer. Methods and Materials: A trial testing external beam radiotherapy (66 Gy within 6.5 weeks) as a single-modality treatment was performed for biopsy-proven squamous cell carcinoma of the thoracic esophagus clinically staged as Stage I and II A (Tz1-Taman, International Union Against Cancer, 1987) in patients aged {>=}80 years. Results: From January 1999 through December 2002, 51 evaluable patients (35 men and 16 women) with a median age of 83 years (range, 80-91 years) were enrolled from 22 institutions. Of the 51 patients, 18 (35%) had Stage Tz1 and 33 (65%) had Stage Tz2-T disease. Radiotherapy could be completed in 47 patients (92%) within 43-58 days (median, 49). The actuarial incidence of Grade 3 or worse cardiopulmonary complications at 3 years was 26%, with 3 early deaths, and correlated significantly with the size of the anteroposterior radiotherapy portals. The median survival time and overall survival rate at 3 years was 30 months and 39% (95% confidence interval, 25-52%), respectively. Conclusion: The results of high-dose radiotherapy in octogenarians are comparable to those in younger patients, but meticulous treatment planning and quality control is required.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 64,
place = {United States},
year = {Wed Mar 15 00:00:00 EST 2006},
month = {Wed Mar 15 00:00:00 EST 2006}
}