Jiang, WanrongSun, XiangdongZhou, BinChenglong, HanFeng, LiuJingwei, ZhengXinchen, Sun2020-11-182020-11-182019-08Jiang Wanrong, Sun Xiangdong, Zhou Bin, Chenglong Han, Feng Liu, Jingwei Zheng, Xinchen Sun. Evaluation of surgery plus postoperative radiotherapy or definitive radiotherapy in older patients with thoracic esophageal squamous cell cancer. Journal of Cancer Research and Therapeutics. 2019 Aug; 15(4): 849-8560973-1482http://imsear.searo.who.int/handle/123456789/213442Purpose: This study investigated the outcome of elderly patients (≥65 years) with thoracic esophageal squamous cell carcinoma (TESCC) treated with esophagectomy and postoperative radiotherapy (PORT) or definitive radiotherapy (DRT). Patients and Methods: One hundred and ninety patients (median age of 72 years) who received PORT (n = 68) or DRT (n = 122) for TESCC were analyzed. Majority of them showed locally advanced disease (T3/4: 70.5%, N+: 70.5%, Stage III: 51.6%). Compared to patients who received DRT, those who received PORT had lower Age-Adjusted Charlson Comorbidity Index (AACCI) scores (2.49 ± 0.61 vs. 3.73 ± 1.28, χ2 = 7.283; P = 0.000) and higher Karnofsky Performance Scale (KPS) (χ2 = 9.016; P = 0.003) and were of younger ages (68.90 ± 3.00 vs. 75.17 ± 5.71, χ2 = 9.925; P = 0.000). Results: Overall survival (OS) was significantly higher in the PORT group (median, 61.2 months; 95% confidence interval [CI], 46.04–76.36) than in the DRT group (median, 24.37 months; 95% CI, 15.43–33.31). Multivariate analysis showed that treatment method (hazard ratio [HR]: 2.38, 95% CI, 1.46–3.90; P = 0.001), clinical T stage (HR: 0.57, 95% CI, 0.34–0.95; P = 0.031), and lymph node metastasis (HR: 0.51, 95% CI, 0.31–0.84; P = 0.008) were independent prognostic factors. Regarding subgroup analysis, OS of patients receiving PORT was significantly higher than that of DRT in the T3–4 group (HR: 2.98, 95% CI, 1.80–4.92; P = 0.000) and the N+ group (HR: 2.20, 95% CI, 1.26–3.83; P = 0.006). Conclusions: The efficacy of PORT for the treatment of elderly TESCC patients was superior to DRT. With regard to AACCI, KPS, and age, DRT is still a treatment option for elderly TESCC patients, especially for those >75 years of ageJournal ArticleIndiaDepartment of Radiotherapy, The First Affiliated Hospital of Nanjing Medical College; Department of Radiotherapy, Jinling Hospital, Nanjing, ChinaDepartment of Radiotherapy, Jinling Hospital, Nanjing, ChinaDepartment of Radiotherapy, Jinling Hospital, Nanjing, ChinaDepartment of Radiotherapy, Jinling Hospital, Nanjing, ChinaDepartment of Radiotherapy, Jinling Hospital, Nanjing, ChinaDepartment of Clinical Research Center, Eye Hospital Affiliated To Wenzhou Medical University, Wenzhou, ChinaDepartment of Radiotherapy, The First Affiliated Hospital of Nanjing Medical College, Nanjing, China