Treatment-related toxicity and outcomes in older versus younger patients with esophageal cancer treated with neoadjuvant chemoradiation.

ABSTRACT:

Background

Neoadjuvant chemoradiation (nCRT) followed by esophagectomy is the standard treatment for locally advanced esophageal cancer. Older patients are often felt to be poor candidates for nCRT. Limited data is available to guide the use of nCRT in this population.

Methods

A retrospective review of patients treated at a tertiary cancer center between 2002 and 2014 was conducted grouping patients by age (? 65 or?Results125 patients were identified for this study (67 aging <65, and 58???65). In the UVA, advanced age was only associated with increased hematologic toxicity (p?=?.04). After adjusting for covariates in the MVA, there were no significant differences in toxicity between older and younger patients. There were also no differences between overall survival and relapse free survival between age groups. Increased pre-treatment NLR was strongly correlated with advanced age (p?=?.01), increased hospitalizations (p?=?.04), and decreased RFS (p?=?.002).

Conclusions

Older patients who underwent nCRT followed by esophagectomy had similar toxicities and outcomes as younger patients suggesting that nCRT before esophagectomy is safe in select older adults with esophageal cancer. PLR and NLR may serve as prognostic markers of aging, toxicity, and outcomes. Further research is warranted to optimize the therapy of older patients with this disease.

SUBMITTER: Jain R 

PROVIDER: S-EPMC7751616 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature