テラハラ　アツロウ   Terahara Atsuro   寺原　敦朗    所属   東邦大学  医学部 医学科（大森病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Esophageal cancer: definitive chemoradiotherapy for elderly patients.
掲載誌名	正式名：Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E 略　 称：Dis Esophagus ISSNコード：11208694/14422050
巻・号・頁	23(7),pp.572-9
著者・共著者	Wakui R, Yamashita H, Okuma K, Kobayashi S, Shiraishi K, Terahara A†, Sasano N, Ohtomo K, Nakagawa K
発行年月	2010/09
概要	To investigate the efficacy and toxicity of definitive chemoradiotherapy (CRT) for elderly patients with locally advanced esophageal cancer. Twenty-two patients aged over 75 that performed definitive CRT were retrospectively reviewed. The regimen included concurrent CRT consisting of two cycles of chemotherapy (CTx) of platinum and 5-fluorouracil, and radiation therapy (RT) of 50-50.4 Gy (actual range: 45.4-71.4 Gy), and additional CTx where possible. Both CTx and RT were reduced in dose and field where necessary. The disease-free survival rate and the overall survival rate at 3 years were 33.3% +/- 11.4% and 25.9% +/- 10.8%. Grade 4 leukocytopenia and thrombocytopenia occurred in three (14%) and four (18%) patients. Treatment-related death was suspected in up to four (18%) patients at the most. Univariate analyses for disease-free survival showed that neither total radiation dose nor number of total cycles of CTx was significant. The pattern of relapse was predominantly more frequent in the intra-RT field than outside the RT field. For elderly patients, adverse events are frequent, and decreased organ reserve may cause treatment-related death. Reduction in CTx dose or RT field, appropriate only for two cycles of CTx, and careful monitoring may help to minimize toxicity. Physicians should not be too afraid of adverse events or be negative about CRT for elderly patients, as long as comorbidities and complications are managed carefully.
DOI	10.1111/j.1442-2050.2010.01062.x