A Clinical Study Of Radiotherapy And Surgery Of Elderly Patients With Staged Ⅰ～Ⅲ Esophageal Squamous Cell Carcinoma

Objective:To investigate the efficiency of radiotherapy of the elder patients with esophageal squamous cellcancer(ESCC).Methods:From July 2009 to December 2013,307 patients with staged Ⅰ-Ⅲ ESCC were eligible for the analysis.They were divided into two groups fordifferenttreatment,radiotherapy group and operation group respectively.And the survival rateswere evaluated retrospectively,using SPSS17.0software. Results:The 1-,2-and3-year OS rates between two groups were77.8%,44.8%,20.8% and 71.3%,41.80%,25.6%,respectively.Thel-,2-and3-yearDFS rates were62.6%,33.3%,17.7% and52.9%,31.4%,19.3%,respectively.The 1-,2-and3-year LRFS rates were 73.1%,38.8%,19.7% and 68.4%,40%,24.6%, respectively.The 1-,2-and 3-year DMFS rates were66.1%,34%,18.7% and 54.4%,35.6%,21.5%,respectively. There was no significant difference of the two groups. However, patients staged I of operation group had a significantly higher overall survival (P=0.049), median OS was 24 mo in radiotherapy group,35.5 mo in surgery group,there was no significant difference of patients with staged II between the two groups (P=0.824),median OS was 22.9 mo in radiotherapy group,22.7 mo in surgery group,patients staged Ⅲofradiotherapy group had a significantly higheroverall survival (P=0.031),median OS was 22.3mo in radiotherapy group,16.1mo in surgery group,.There was statistical significance of the lymph nodes metastasis between the two groups (x2=4.404,P=0.036), but it did not show significant difference on local recurrence and distant metastasis(P>0.05).Univariate analysis found that the survival of radiotherapy group patients was associated with clinical staging and lymph node metastasis.T-staging, clinical staging and metastasis were prognostic factors in operation group patients.Mutivariate analysis found that T-staging, clinical staging and lymph node metastasis were prognostic factors of all group patients. Conclusion:Patients older than 70 years with staged I ESCC surgery is the first option,however staged Ⅱ and Ⅲ patients can choose radiotherapy.