SynthesisBMC cancer2024
Treatment strategies for elderly patients with locally advanced esophageal cancer: a systematic review and meta-analysis.
Synthesis in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Neoadjuvant Chemoimmunotherapy for Elderly Patients with Locally Advanced Resectable Esophageal Squamous Cell Carcinoma.Annals of surgical oncology · 2026Article
- Surgical treatment strategy for elderly patients with esophageal cancer in the new era: a narrative review.Surgery today · 2025Review
- A comparison of the clinical outcomes of esophagectomy and chemoradiotherapy for patients aged 75 years or older with surgically resectable esophageal squamous cell carcinoma.Esophagus : official journal of the Japan Esophageal Society · 2025Article
- Tailoring treatment for esophageal cancer: a retrospective comparison of chemoradiation with and without esophagectomy.BMC surgery · 2025Article
- A Propensity-Score Matched Analysis to Evaluate Local Treatment Modalities for Esophageal Squamous Cell Carcinoma in Over 80 years on A SEER Database.Clinical interventions in aging · 2025Article
- A nomogram for predicting cancer-specific survival in patients with locally advanced unresectable esophageal cancer: development and validation study.Frontiers in immunology · 2025Article
- Comparison of Blood Inflammation Scores and Their Prognostic Value in Elderly Unresectable Esophageal Squamous Cell Carcinoma Patients Treated with Radiotherapy/Chemoradiotherapy.Journal of inflammation research · 2025Article
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6 authors.
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Abstract
backgroundNeoadjuvant chemoradiotherapy (nCRT) followed by surgery remains a standard of care for resectable esophageal cancer (EC), and definitive chemoradiotherapy (dCRT) is an alternative for unresectable diseases. However, it is controversial for the use of the two aggressive regimens in elderly patients.
methodsWe systematically searched multiple databases for studies comparing overall survival (OS) and/or progression-free survival (PFS) between dCRT and surgery (nCRT + surgery or surgery alone) or between dCRT and radiotherapy (RT) alone in elderly patients (age ≥ 65 years) until March 28, 2024. Statistical analysis was performed using random-effects model.
resultsFourty-five studies with 33,729 patients were included. dCRT significantly prolonged OS (hazard ratio [HR] = 0.64, 95% confidence interval [CI]: 0.58-0.70) and PFS (HR = 0.67, 95% CI: 0.60-0.76) compared to RT alone for unresectable EC, and resulted in a worse OS compared to surgery for resectable cases (HR = 1.34, 95% CI: 1.23-1.45). Similar results of OS were also observed when the multivariate-adjusted HRs were used as the measure of effect (dCRT vs. RT alone: HR = 0.65, 95% CI: 0.58-0.73; dCRT vs. surgery: HR = 1.49, 95% CI: 1.28-1.74). Subgroup analyses according to age group (≥ 70, ≥ 75, or ≥ 80 years), study design, study region, histological type, radiation field, chemotherapy regimen revealed comparable results.
conclusionsnCRT + surgery is likely a preferred strategy for elderly patients with good physiological conditions; and dCRT is a better alternative for unresectable cases. Advanced age alone does not appear to be a key predictor for the tolerability of the two aggressive treatments.
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