Feasibility and efficiency of concurrent chemoradiotherapy with capecitabine and cisplatin versus radiotherapy alone for elderly patients with locally advanced esophageal squamous cell carcinoma: Experience of two centers

BACKGROUND: The purpose of this retrospective study was to evaluate the feasibility and efficacy of definitive concurrent chemoradiotherapy (CCRT) with capecitabine and cisplatin for elderly patients with locally advanced esophageal squamous cell carcinoma. METHODS: A total of 90 patients were included from two different centers. Forty‐nine patients were treated with CCRT consisting of capecitabine (850 mg/m(2), oral, twice a day for 1–14 days) and cisplatin (20 mg/m(2)) weekly during radiotherapy (RT). The remaining 41 patients were treated with RT alone. The overall response, overall survival, progression‐free survival, and toxicity rates were recorded. RESULTS: Compared to the RT group (51.2%; P = 0.029), the overall response rate in the CCRT group (73.5%) was obviously higher. A complete response was achieved in 34.7% and 14.6% of patients in the CCRT and RT groups, respectively (P = 0.030). Median progression‐free and median overall survival rates were significantly higher in the CCRT group (24.7 and 30.6 months; P < 0.05) compared to the RT group (16.6 and 18.7 months). Acute toxic effects were more severe in the CCRT group, but no significant difference in grade 3 or 4 acute toxicities was observed between the groups. CONCLUSION: Both CCRT with capecitabine and cisplatin and RT alone are feasible to treat elderly patients and yield a good performance status with locally advanced esophageal squamous cell carcinoma. CCRT improved the tumor response without increasing the side effects compared to RT alone. CCRT is recommended for patients over 65 with good performance status.