Objective To analyze the outcomes and prognostic factors for elderly patients (age≥70 years old) with esophageal squamous cell carcinoma treated after definitive chemoradiotherapy. Methods The clinical data of 293 esophageal squamous cell cancer patients who were aged 70 years or older and received definitive radiotherapy with or without chemotherapy from January of 2009 to June of 2015 were retrospectively analyzed. Of the 293 patients, 113 received concurrent chemoradiotherapy, and 60 received radiotherapy alone. The Kaplan-Meier method was used to calculate overall survival (OS), the log-rank test was performed for univariate analysis, and the Cox regression model was used for multivariate analysis. Results The 1-, 2-, and 3-year OS rates was 68.8%, 40.3% and 27.2%, respectively;and the median survival time was 21 months (95% CI: 18.6-23.4 months). The 3-year OS rates for the patients treated with concurrent chemoradiotherapy and radiotherapy alone was 32.3% and 23.8%, respectively (P=0.021). Univariate analysis indicated that lesion length, clinical stage, and treatment modality were prognostic factors for OS (P=0.010, 0.000 and 0.021). Multivariate analysis identified that clinical stage and treatment modality were independent prognostic factors for OS (P=0.001 and 0.012). Conclusion For elderly patients with esophageal squamous cell carcinoma, 3D CRT is safe and effective, and concurrent chemoradiotherapy could bring a better overall survival.%目的 探讨≥70岁食管鳞癌患者根治性放化疗的疗效及预后的影响因素.方法 回顾性分析2009年1月至2015年6月收治的293例接受根治性放化疗的年龄≥70岁的食管鳞癌初治患者的临床资料,其中同步放化疗113例,单纯放疗180例.采用Kaplan-Meier法计算生存率并进行log-rank检验及单因素分析,Cox回归模型行多因素分析.结果 1、2、3年生存率分别为68.8%、40.3%和27.2%,中位生存时间为21个月(95% CI为18.6~23.4个月).同步放化疗和单纯放疗3年生存率分别为32.3%和23.8%(P=0.021).单因素分析显示肿瘤长度、临床分期和治疗方式是影响总生存率的因素(P=0.010,0.000和0.021).多因素分析显示临床分期、治疗方式是影响总生存率的独立预后因素(P=0.001和0.012).结论 对于老年食管鳞癌患者,三维适形放疗是安全有效的,同步放化疗能够提高患者治疗效果.
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