Combined modality chemoradiation in elderly oesophageal cancer patients Journal Article

Authors: Anderson, S. E.; Minsky, B. D.; Bains, M.; Hummer, A.; Kelsen, D.; Ilson, D. H.
Article Title: Combined modality chemoradiation in elderly oesophageal cancer patients
Abstract: We present a single institution experience with 5-FU, mitomycin-C based chemoradiation for the primary treatment of elderly patients with oesophageal cancer. Twenty-five patients with a median age of 77 years (range 66-88) with a diagnosis of stage II-III squamous cell or adenocarcinoma of the oesophagus were treated at Memorial Sloan Kettering from 1996 to 2001 with two cycles of concurrent 5-FU, mitomycin-C and 50.4 Gy. Owing to age and comorbidity, these patients were not considered surgical candidates. The Charlson comorbidity score was used to evaluate patient comorbidity. Nine patients (36%) experienced grade 3-4 haematologic toxicity. Of the 23 patients evaluable for response, 17 patients (68%) had a negative post-treatment endoscopy and CT scan without evidence of progressive disease. Eleven patients (44%) are alive and 10 (40%) remain without evidence of recurrent or progressive oesophageal cancer at a median follow-up of 35 months. The median overall survival was 35 months and 2-year survival 64%. There was no significant difference in overall survival between Charlson score ≤2 and those with a score ≥2 (P=0.10). Similar survival was observed for patients with adenocarcinoma or squamous carcinoma. Primary chemoradiation with two cycles of 5-FU, mitomycin-C, and 50.4 Gy in elderly patients is an active regimen with moderate toxicity, despite the advanced age and heavy comorbidity burden of this cohort. Patients with local/regional oesophageal cancer with adequate functional status should not be excluded from potentially curative treatment based on age alone. © 2007 Cancer Research UK.
Keywords: cancer chemotherapy; cancer survival; clinical article; treatment response; aged; aged, 80 and over; survival analysis; neutropenia; cancer recurrence; salvage therapy; squamous cell carcinoma; carcinoma, squamous cell; fluorouracil; drug dose reduction; drug withdrawal; cancer patient; cancer radiotherapy; radiation dose; combined modality therapy; cancer staging; follow up; adenocarcinoma; computer assisted tomography; multiple cycle treatment; anemia; blood toxicity; esophagitis; leukopenia; thrombocytopenia; antineoplastic combined chemotherapy protocols; dehydration; continuous infusion; age; drug fever; gastrointestinal toxicity; heart failure; comorbidity; brachytherapy; mitomycin c; mitomycin; esophagus cancer; esophageal adenocarcinoma; endoscopy; photodynamic therapy; functional status; esophageal neoplasms; granulocytopenia; cellulitis; elderly patients; oesophageal cancer
Journal Title: British Journal of Cancer
Volume: 96
Issue: 12
ISSN: 0007-0920
Publisher: Nature Publishing Group  
Date Published: 2007-06-18
Start Page: 1823
End Page: 1827
Language: English
DOI: 10.1038/sj.bjc.6603821
PUBMED: 17533399
PROVIDER: scopus
PMCID: PMC2359964
Notes: --- - "Cited By (since 1996): 13" - "Export Date: 17 November 2011" - "CODEN: BJCAA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Amanda J Hummer
    60 Hummer
  2. Bruce Minsky
    263 Minsky
  3. David H Ilson
    274 Ilson
  4. Manjit S Bains
    229 Bains
  5. David P Kelsen
    341 Kelsen