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Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age

Although the Japan Clinical Oncology Group trial demonstrated that neoadjuvant chemotherapy (NAC) with 5-fluorouracil plus cis-diamminedichloroplatinum had significant survival benefits, it excluded elderly patients aged ≥ 76 years. Therefore, our study aimed to evaluate the tolerability of NAC in e...

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Autores principales: Suzuki, Takafumi, Ishibashi, Yusuke, Tsujimoto, Hironori, Sugasawa, Hidekazu, Wakamatsu, Kotaro, Kouzu, Keita, Itazaki, Yujiro, Sugihara, Takao, Harada, Manabu, Ito, Nozomi, Kishi, Yoji, Ueno, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nagoya University 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350567/
https://www.ncbi.nlm.nih.gov/pubmed/35967940
http://dx.doi.org/10.18999/nagjms.84.2.388
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author Suzuki, Takafumi
Ishibashi, Yusuke
Tsujimoto, Hironori
Sugasawa, Hidekazu
Wakamatsu, Kotaro
Kouzu, Keita
Itazaki, Yujiro
Sugihara, Takao
Harada, Manabu
Ito, Nozomi
Kishi, Yoji
Ueno, Hideki
author_facet Suzuki, Takafumi
Ishibashi, Yusuke
Tsujimoto, Hironori
Sugasawa, Hidekazu
Wakamatsu, Kotaro
Kouzu, Keita
Itazaki, Yujiro
Sugihara, Takao
Harada, Manabu
Ito, Nozomi
Kishi, Yoji
Ueno, Hideki
author_sort Suzuki, Takafumi
collection PubMed
description Although the Japan Clinical Oncology Group trial demonstrated that neoadjuvant chemotherapy (NAC) with 5-fluorouracil plus cis-diamminedichloroplatinum had significant survival benefits, it excluded elderly patients aged ≥ 76 years. Therefore, our study aimed to evaluate the tolerability of NAC in elderly patients with esophageal cancer. Classified 174 patients with clinical stage II/III esophageal cancer who underwent esophagectomy from 2010 to 2020 into the E (aged ≥ 76 years; 55 patients) and Y (aged < 76; 119 patients) groups, and retrospectively investigated for clinicopathological findings, tolerability of NAC, relative dose intensity (RDI) and short- and long-term result. Patients who received NAC were fewer in the E group than in the Y group (51% vs 77%, p = 0.001). The E group had relatively lower completion rate of NAC (71% vs 85%, p = 0.116) and significantly lower mean RDI of 5-fluorouracil and cis-diamminedichloroplatinum than the Y group (73% vs 89%, p < 0.001). However, histological and radiological were comparable between both groups. Severe adverse events (grade ≥ 3) were relatively frequent (E, 42.9%; Y, 27.5%, p = 0.091), especially, neutropenia was significantly more frequent in the E group (25.0% vs 7.7%, p = 0.022). There were no differences in the incidence of postoperative complications between with and without NAC in both E and Y groups. Elderly patients with esophageal cancer might be more susceptible to toxicity of NAC. Hence, adequate case selection and careful of dose reduction are needed for elderly with esophageal cancer.
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spelling pubmed-93505672022-08-11 Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age Suzuki, Takafumi Ishibashi, Yusuke Tsujimoto, Hironori Sugasawa, Hidekazu Wakamatsu, Kotaro Kouzu, Keita Itazaki, Yujiro Sugihara, Takao Harada, Manabu Ito, Nozomi Kishi, Yoji Ueno, Hideki Nagoya J Med Sci Original Paper Although the Japan Clinical Oncology Group trial demonstrated that neoadjuvant chemotherapy (NAC) with 5-fluorouracil plus cis-diamminedichloroplatinum had significant survival benefits, it excluded elderly patients aged ≥ 76 years. Therefore, our study aimed to evaluate the tolerability of NAC in elderly patients with esophageal cancer. Classified 174 patients with clinical stage II/III esophageal cancer who underwent esophagectomy from 2010 to 2020 into the E (aged ≥ 76 years; 55 patients) and Y (aged < 76; 119 patients) groups, and retrospectively investigated for clinicopathological findings, tolerability of NAC, relative dose intensity (RDI) and short- and long-term result. Patients who received NAC were fewer in the E group than in the Y group (51% vs 77%, p = 0.001). The E group had relatively lower completion rate of NAC (71% vs 85%, p = 0.116) and significantly lower mean RDI of 5-fluorouracil and cis-diamminedichloroplatinum than the Y group (73% vs 89%, p < 0.001). However, histological and radiological were comparable between both groups. Severe adverse events (grade ≥ 3) were relatively frequent (E, 42.9%; Y, 27.5%, p = 0.091), especially, neutropenia was significantly more frequent in the E group (25.0% vs 7.7%, p = 0.022). There were no differences in the incidence of postoperative complications between with and without NAC in both E and Y groups. Elderly patients with esophageal cancer might be more susceptible to toxicity of NAC. Hence, adequate case selection and careful of dose reduction are needed for elderly with esophageal cancer. Nagoya University 2022-05 /pmc/articles/PMC9350567/ /pubmed/35967940 http://dx.doi.org/10.18999/nagjms.84.2.388 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ).
spellingShingle Original Paper
Suzuki, Takafumi
Ishibashi, Yusuke
Tsujimoto, Hironori
Sugasawa, Hidekazu
Wakamatsu, Kotaro
Kouzu, Keita
Itazaki, Yujiro
Sugihara, Takao
Harada, Manabu
Ito, Nozomi
Kishi, Yoji
Ueno, Hideki
Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age
title Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age
title_full Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age
title_fullStr Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age
title_full_unstemmed Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age
title_short Tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age
title_sort tolerability of neoadjuvant chemotherapy for esophageal cancer in elderly patients over 76 years of age
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350567/
https://www.ncbi.nlm.nih.gov/pubmed/35967940
http://dx.doi.org/10.18999/nagjms.84.2.388
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