Single modality radical radiotherapy is an acceptable alternative for the older patient with squamous cell carcinoma of the oesophagus

Derby, S., Forshaw, M., Lowrie, C., Grose, D., Marashi, H., McLoone, P. , Wilson, C. and McIntosh, D. (2021) Single modality radical radiotherapy is an acceptable alternative for the older patient with squamous cell carcinoma of the oesophagus. BMJ Open Gastroenterology, 8(1), e000492. (doi: 10.1136/bmjgast-2020-000492) (PMID:33504498) (PMCID:PMC7843319)

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Abstract

Background: Oesophageal cancer remains a common cause of cancer mortality worldwide. Increasingly, oncology centres are treating an older population and comorbidities may preclude multimodality treatment with chemoradiotherapy. We review outcomes of radical radiotherapy in an older population treating Squamous Cell Carcinoma (SCC) oesophagus. Methods: Patients over 65 years receiving radiotherapy for SCC oesophagus between 2013-2016 in the West of Scotland were identified. Kaplan-Meier and Cox-regression analysis were used to compare overall survival (OS) between patients treated with radical radiotherapy (RT) and radical chemoradiotherapy (CRT). Results: There were 83 patients over 65 years treated with either RT (n=21) or CRT (n=62). There was no significant difference in median OS between CRT versus RT (26.8 months vs 28.5 months, p=0.92). All patients receiving RT completed their treatment whereas 11% of CRT patients did not complete treatment. Conclusion: Survival in this non-trial older patient group managed with CRT is comparable to that reported in previous trials. RT shows better than expected outcomes which may reflect developments in radiotherapy technique. This review supports RT as an alternative in older patients, unfit for concurrent treatment.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Forshaw, Mr Matthew and McLoone, Mr Philip and Derby, Dr Sarah and Grose, Dr Derek
Authors: Derby, S., Forshaw, M., Lowrie, C., Grose, D., Marashi, H., McLoone, P., Wilson, C., and McIntosh, D.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMJ Open Gastroenterology
Publisher:BMJ Publishing Group
ISSN:2054-4774
ISSN (Online):2054-4774
Published Online:27 January 2021
Copyright Holders:Copyright © Author(s) (or their employer(s)) 2021
First Published:First published in BMJ Open Gastroenterology 8(1):e000492
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
306587The TRACC Programme: to Train and Retain Academic Cancer CliniciansOwen SansomCancer Research UK (CRUK)C7932/A29706CS -Translational Research Centre