CLINICAL-FEATURES OF ESOPHAGEAL CANCER IN THE OCTOGENARIAN TREATED BYDEFINITIVE RADIOTHERAPY - A MULTIINSTITUTIONAL RETROSPECTIVE SURVEY

Background: As age-related infirmity often influences treatment option s and outcome of esophageal cancer, the optimization of treatment for the elderly, especially in octogenarians, has been the subject of cons iderable debate. Methods: We performed a retrospective, multi-institut ional survey to assess the effect of age on the outcome of definitive radiotherapy for esophageal cancer by a questionnaire sent to eight in stitutions in Japan. Results: There were 362 evaluable replies. The pa tients included 317 males and 45 females, with a median age of 72 year s (range 35-93 years), and 96% had squamous cell carcinoma. There were 30 clinical stage I, 71 stage IIA, 17 stage IIB, 113 stage III and 11 6 stage IV cases. The stage was not specified in 16 cases. Multiple co -morbidities existed in 40% of the patients who were 70 years of age o r older. There was no statistically significant age-related difference in the incidence of adverse reactions to radiotherapy (P > 0.05). Ove rall survival was more significantly affected by Karnofsky Performance Status than by the patient's age. The influence of performance status on cumulative survival for stage I and II disease was more pronounced in patients in their 80s. Conclusion: The safety of radiotherapy for esophageal carcinoma is not influenced by the patient's age, Because t he performance status strongly influenced survival, the multi-discipli nary assessment of functional status is mandatory for optimizing the c hoice of treatment for patients in their 80s with esophageal cancer.