Abstract:Objective To investigate the long-term survival of esophageal squamous cell carcinoma(ESCC) patients of different ages after three-dimensional conformal radiotherapy (3DCRT). MethodsFrom July 2003 to September 2008, 769 patients with stage I-III ESCC were eligible for the analysis. All patients were treated with 3DCRT. The prescribed dose was 50-70 Gy (median, 60 Gy), 1.8-2.0 Gy per fraction, 5 fractions per week. The Kaplan-Meier method was used to calculate overall survival (OS) and local control (LC) rates;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The follow-up rate was 98.3%. For all patients, the 1-, 3-, and 5-year LC rates were 76.3%, 52.8%, and 48.5%, respectively, and the 1-, 3-, and 5-year OS rates were 70.1%, 36.2%, and 23.0%, respectively. The 1-, 3-, and 5-year OS rates were 71.2%, 38.8%, and 24.9%, respectively, for patients aged 45-74 years, versus 69.6%, 26.6%, and 15.4% for patients aged 75-89 years (P=0.008). Multivariate prognostic analysis showed that age was also a prognostic factor in ESCC patients after 3DCRT. A total of 620 patients died. Patients aged 45-74 years had a significantly higher proportion of individuals that died of distant metastasis (23.9% vs. 14.2%, P=0.009), while patients aged 75-89 years had a significantly higher proportion of individuals that died of non-cancer diseases (14.1% vs. 4.9%, P=0.000). Conclusions Survival varies between ESCC patients of different ages after 3DCRT. The survival of elderly ESCC patients is poor, and the relatively high mortality from non-cancer diseases may be an important reason for poor survival.
Zhang Andu,Han Chun,Lan Kuntian et al. Analysis of age and prognosis in patients with esophageal squamous cell carcinoma after 3DCRT [J]. Chinese Journal of Radiation Oncology, 2014, 23(5): 392-395.