M. Kawashima et al., CLINICAL-FEATURES OF ESOPHAGEAL CANCER IN THE OCTOGENARIAN TREATED BYDEFINITIVE RADIOTHERAPY - A MULTIINSTITUTIONAL RETROSPECTIVE SURVEY, Japanese Journal of Clinical Oncology, 28(5), 1998, pp. 301-307
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.