Clinical features, outcomes and treatment-related pneumonitis in elderly patients with esophageal carcinoma.

[esophageal carcinoma]

To investigate the clinical features and prognoses of elderly patients with esophageal carcinoma and to compare the effects of radiotherapy and rates of treatment-related pneumonitis (TRP ) between elderly and non-elderly patients .A total of 236 patients with esophageal carcinoma who received radiotherapy between 2002 and 2012 were enrolled . The patients were divided into two groups : an elderly group (age ≥ 65 years ) and a non-elderly group (age < 65 years ). The tumor position and stage , lymph node and distant metastases , and incidence and severity of TRP were compared . Multivariate analysis was applied to identify independent prognostic factors .The median overall survival times after radiotherapy in the elderly and non-elderly groups were 18 .5 and 20 .5 mo , respectively . Cox regression analysis showed that TRP grade and tumor -node-metastasis (TNM ) stage were independent prognostic factors in the elderly group . High -dose radiotherapy (> 60 Gy ) was associated with a high incidence of TRP . Tumor TNM staging was significantly different between the two groups in which TRP occurred . Multivariate analysis showed that TNM stage was an independent prognostic factor . Esophageal carcinoma in elderly patients was relatively less malignant compared with that in non-elderly patients .An appropriate dose should be used to decrease the incidence of TRP in radiotherapy , and intensity modulated radiation therapy should be selected if possible .