| ObjectiveIntensity modulated conformal radiotherapy is one of the important methods for the treatment of patients with esophageal cancer.When most elderly patients are diagnosed with esophageal cancer,they have missed the best time for surgical treatment,and radiotherapy has become their first choice for elderly patients with esophageal cancer who are in poor physical condition and can not tolerate surgery or refuse surgical treatment.Therefore,this paper observed the efficacy of intensity-modulated conformal radiotherapy in patients with stage II / III esophageal squamous cell carcinoma over 65 years old,compared the advantages and disadvantages of concurrent chemotherapy（CCRT）and radiotherapy alone（RT）in elderly patients,combined with the toxic and side effects of radiotherapy and chemotherapy,and analyzed the factors affecting the prognosis,To provide a theoretical basis for the treatment of similar patients in the future.methodA total of 414 patients with esophageal cancer treated in the tumor radiotherapy department of Chuzhou Hospital Affiliated to Anhui Medical University from January 1,2015 to June 30,2018 were collected.A total of 90 patients over 65 years old with stage II / III esophageal squamous cell carcinoma were selected.The clinical data of the patients were counted,including gender,age,lesion location,lesion length,GTV volume,T stage,N stage,clinical stage,radiotherapy dose,treatment method,chemotherapy scheme and targeted treatment.SPSS 23.0 software was used for statistical analysis.The counting data were expressed in n（%）χ 2 inspection.The survival curve was drawn by Kaplan Meier method,and the median survival time and 1,2,3-year survival rate were calculated.Log rank method and Cox regression model were used to test the difference,and univariate and multivariate prognostic analysis was carried out.resultA total of 90 patients were included in this group.There were 54 males and 36females;The median age was 75.5 years（range 66 91 years）;Tumor location:neck + upper thoracic segment in 12 cases,middle thoracic segment in 58 cases,lower thoracic segment in 20 cases;Lesion length: < 6cm in 66 cases,≥ 6cm in 24cases;Gtv volume: < 38 cm 3 62 cases,≥ 38 cm 3 28 cases;T stage: 2 cases in T1 stage,33 cases in T2 stage and 55 cases in T3 stage;N stage: 14 cases in N0 stage,72 cases in N1 stage and 4 cases in N2 stage;Clinical stage: 42 cases in stage II and48 cases in stage III;Irradiation dose: < 60 Gy in 22 cases,≥ 60 Gy in 68 cases;There were 58 cases of radiotherapy alone,32 cases of concurrent radiotherapy and chemotherapy,and chemotherapy drugs were used: 8 cases of single drug capecitabine,14 cases of single drug letitrexed,2 cases of capecitabine combined with oxaliplatin,2 cases of letitrexed combined with oxaliplatin,3 cases of letitrexed combined with cisplatin,and letitrexed combined with nedaplatin 3 cases;Targeted therapy was used in 2 cases,all of which were apatinib.The median survival time was 18 months.The 1-year,2-year and 3-year survival rates were 77.8%,26.7% and 5.6% respectively.Univariate analysis showed that age,lesion length,GTV volume,T stage,N stage,clinical stage,radiotherapy dose and treatment method were closely related to the prognosis of patients with stage II /III esophageal squamous cell carcinoma over 65 years old（χ 2 =7.977,4.731,9.465,8.900,12.067,26.782,8.452,3.936 P=0.005,0.030,0.002,0.012,0.002,0.000,0.004,0.047）。 Multivariate analysis showed that GTV volume,N stage,radiotherapy dose and treatment method were independent factors affecting the survival of patients with stage II / III esophageal squamous cell carcinoma over 65 years old（χ 2 =4.593,5.973,6.938,6.819 P=0.032,0.015,0.008,0.009）。ConclusionIntensity modulated conformal radiotherapy is an effective treatment for patients with stage II / III esophageal squamous cell carcinoma over 65 years old.The toxic and side effects are controllable,which makes the survival benefit of patients.Among them,GTV volume,N stage,treatment method and radiotherapy dose are independent factors affecting the prognosis. |
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