Chemoradiotherapy (CRT) is an effective treatment and does not present major toxicity for elderly patients with esophageal cancer, according to the results of a study released in an early online publication of the November issue of the British Journal of Cancer.
The esophagus is a tube that carries food from the mouth to the stomach. Esophageal cancer is relatively uncommon, but is one of the most aggressive and deadly forms of cancer. It is the eighth most common cancer, but the sixth cause of cancer death worldwide. Standard treatment for esophageal cancer may include chemotherapy, radiation therapy, and/or surgery.
Historically, treatment of elderly patients with esophageal cancer has been challenging because it is believed that the elderly cannot tolerate the side effects associated with treatment. However, there is very little data regarding the outcomes and side effects associated with CRT in elderly patients with locally advanced esophageal cancer.
Researchers in the UK conducted a study in 109 patients over the age of 70 with locally advanced esophageal cancer. The patients received CRT, consisting of radiation plus cisplatin-based chemotherapy. In this study, 38.5% of patients received the planned treatment, while 53.2% required a dose adjustment. Severe side effects (grade 3) occurred in 23.8% of patients, with 16.5% of patients being hospitalized.
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Six to eight weeks after completing CRT, patients underwent endoscopy (examination of the esophagus through a long, lighted tube) and computed tomography scan (a series of detailed pictures of areas inside the body taken from different angles). The results indicated that 57.8% of patients experienced a complete response (total disappearance of cancer in response to treatment) and the two-year survival was 35.5%
The researchers concluded that CRT was an effective treatment for elderly patients, with no major side effects. In addition, they noted that their results showed that CRT in elderly patients produced similar response rates and overall survival as typically reported in younger patients treated with the same regimen.
 Tougeron D, Di Fiore F, Thurea S, et al. Safety and outcome of definitive chemoradiotherapy in elderly patients with oesophageal cancer. British Journal of Cancer. 2008; 99: 1586-1592.