Survival benefit evaluation of radiotherapy in esophageal cancer patients aged 80 and older

PURPOSE: To evaluate the survival benefit of radiotherapy (RT) in esophageal cancer (EC) patients aged ≥ 80. MATERIALS AND METHODS: Records for all EC patients aged ≥ 65 years were extracted from the Surveillance, Epidemiology, and End Results database. Chi-square test compared the characteristic and treatment between patients aged ≥ 80 with those aged 65–79. Focusing on patients aged ≥ 80, we employed multivariable logistic regression to identify the association between selection of RT and patients’ characteristics. Survival curve was employed to visualize the survival rate and multivariable Cox proportional hazard model was established to quantify the effect of RT on overall survival (OS) and cancer special survival (CSS). RESULTS: Patients aged ≥ 80 were more likely to be white male and have localized EC (all P < 0.001). Selection of RT in patients aged ≥ 80 were associated with cancer histology (P < 0.001), grade (P = 0.024) and stage (P < 0.001). RT significantly improved the OS (hazard ratio(HR) = 0.717) and CSS (HR = 0.722) (all P < 0.001). Further stratified analysis found the improvement were only significant in the localized (OS HR = 0.662; CSS HR=0.652) and regional stage patients (OS HR = 0.571; CSS HR = 0.581) (all P < 0.001). CONCLUSIONS: Our study suggested EC patients aged ≥ 80 benefit from RT only if the cancer is in localized/regional stage.