Safety And Effcacy Of Radiation And Chemoradiation In Patients Over 70 Years Old With Advance Esophageal Squamous Cell Carcinoma

Objective: In this study,we retrospectively analyzed the treatment of advanced esophageal squamous cell carcinoma in elderly patients over 70 years of age.All patients were divided into two groups(chemoradiotherapy group and Single radiotherapy group),to evaluate the safety of patients and the prognostic factors that may affect survival,to explore whether chemoradiotherapy regimen can make the better for elderly patients with esophageal squamous cell carcinoma more obvious,To provide a reference for the clinician to optimize the treatment of esophageal cancer in the elderly.Methods: We retrospectively analyzed the clinical data of 62 patients with advance esophageal squamous cell carcinoma aged over 70 years old who had not been surgically treated with chemoradiotherapy or radiotherapy alone from March 2008 to June 2016.Including chemoradiotherapy group of 28 cases,radiotherapy alone group of 36 cases.Radiotherapy techniques using intensity modulated radiotherapy technology,and we use the prescription dose is 6MV-X line: PGTV56.0-68.2Gy/28-31 f,PCTV50.4-60Gy/28-31 f.The chemotherapy regimen uses DF regimen or TP regimen.To observe the toxic and side effects of patients,to evaluate the short-term efficacy and conduct the survival analysis of the results.Results: 1,2,and 3 year survival rates were 56.4%,27.6%,13.8% and 75.0%,42.3% and29.9% respectively in the radiotherapy group and chemoradiotherapy group,respectively.The difference was statistically significant(P = 0.043).Univariate analysis showed that gender,smoking history,drinking history,comorbidities,weight loss,tumor location,N stage,regardless of the dose packet prognosis,and clinical stage,tumor length,T stage,ECOG points,short-term efficacy in patients with an impact Survival prognostic factors.Multivariate analysis showed that the short-term efficacy became an independent prognostic factor affecting patient survival.Observationed the short-term response rate in the end of therapy.The overall response rate(CR+PR)of radiotherapy group 64.7%,that of chemoradiotherapy alone group 92.8%,P = 0.008,the two groups were statistically significant.In the radiotherapy alone group and chemoradiotherapy group were 1 to 3 grade leukopenia occurred.In the radiotherapy alone group and chemoradiotherapy group occurred 1 to 3 grade leukopenia,the two groups of grade 3 or more leukopenia were 2.9% and 21.4%,and there are statistically different(P = 0.015)In the radiotherapy alone group,1,2 grade neutropenia occurred,no more than 3 reactions occurred.chemoradiotherapy group occurred 1 to 4 neutropenia,3 or more neutrophil reaction rate was 25%,two groups of neutropenia was statistically significant(P = 0.008.)Gastrointestinal reaction,the incidence of 1 level response in radiotherapy alone group was 14.7%,did not appear a higher level of response,chemoradiotherapy group all occurred 1 to 3 gastrointestinal reactions,3 or more response rate of 7.1 %,Two groups of gastrointestinal reactions were statistically significant(P = 0.000.)Conclusion: Patients enrolled in this study,compared with radiotherapy alone,chemoradiotherapy in the near future effect can achieve better disease efficiency,in the long-term prognosis can improve the over survival of patients.Multivariate analysis showed that T staging was an independent prognostic factor affecting patient survival.In the toxic and side effects,the elderly patients with esophageal squamous cell carcinoma in the chemoradiotherapy group than the radiotherapy group showed leukopenia,neutropenia,blood toxicity and gastrointestinal reactions is more obvious,especially 3 or more toxic side effects.