Clinical Research Papers:
Survival benefit evaluation of radiotherapy in esophageal cancer patients aged 80 and older
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Shan Huang1, Shuyu Zheng2, Tuotuo Gong2, Hongbing Ma1, Yue Ke1, Songchuan Zhao3, Wenyu Wang4, Lijun Jia5 and Xiaozhi Zhang2
1Department of Radiotherapy, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
2Department of Radiotherapy, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
3Department of Spine Surgery, Honghui Hospital, Health Science Center, Xi’an Jiaotong University, Xi’an, China
4Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
5Department of Oncology, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
Xiaozhi Zhang, email: email@example.com
Keywords: esophageal cancer; aged 80 and older; radiotherapy; survival; stage
Received: June 27, 2017 Accepted: November 15, 2017 Published: December 04, 2017
Purpose: To evaluate the survival benefit of radiotherapy (RT) in esophageal cancer (EC) patients aged ≥ 80.
Materials and Methods: Records for all EC patients aged ≥ 65 years were extracted from the Surveillance, Epidemiology, and End Results database. Chi-square test compared the characteristic and treatment between patients aged ≥ 80 with those aged 65–79. Focusing on patients aged ≥ 80, we employed multivariable logistic regression to identify the association between selection of RT and patients’ characteristics. Survival curve was employed to visualize the survival rate and multivariable Cox proportional hazard model was established to quantify the effect of RT on overall survival (OS) and cancer special survival (CSS).
Results: Patients aged ≥ 80 were more likely to be white male and have localized EC (all P < 0.001). Selection of RT in patients aged ≥ 80 were associated with cancer histology (P < 0.001), grade (P = 0.024) and stage (P < 0.001). RT significantly improved the OS (hazard ratio(HR) = 0.717) and CSS (HR = 0.722) (all P < 0.001). Further stratified analysis found the improvement were only significant in the localized (OS HR = 0.662; CSS HR=0.652) and regional stage patients (OS HR = 0.571; CSS HR = 0.581) (all P < 0.001).
Conclusions: Our study suggested EC patients aged ≥ 80 benefit from RT only if the cancer is in localized/regional stage.
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