BACKGROUND The aim of the present study was to assess the efficacy of concurrent chemoradiotherapy (CRT) or radiotherapy alone (RT-alone) in elderly patients with esophageal squamous cell carcinoma (ESCC). METHODS The clinical data of patients with ESCC treated with RT-alone or CRT were collected and retrospectively reviewed. The 1-, 3- and 5-year overall survival (OS) rates and the clinical characteristics correlated with survival were analyzed statistically. Propensity score matching (PSM) analyses were used to compensate for differences in baseline characteristics between the CRT and RT-alone groups to confirm the survival difference. RESULTS A total of 729 patients fulfilling the inclusion criteria were reviewed. Diabetes, primary tumor volume (pTV), primary tumor location (pTLo), clinical T stage,(cT) clinical N stage (cN), clinical M stage (cM) and short-term response to RT were independent factors influencing OS (P = 0.002-0.044). The 5-year OS rate was 26.6, 26.0 and 30.1% in the whole cohort, RT-alone and CRT groups, respectively. The survival difference between RT alone and CRT was not significant before or following PSM. Compared with the corresponding subgroups treated with RT alone, CRT significantly benefited patients with diabetes (P = 0.003), cT4 (P = 0.030) and cN0 (P = 0.049), whereas no benefit was identified between CRT and RT alone in the other subgroups, including cT1-3, cN1, cM, pTLo, pTV, age and gender. CONCLUSIONS CRT with the current chemotherapy regimens may not improve the survival of elderly ESCC patients compared to RT-alone, except in patients with cT4 stage, cN0 stage or diabetes. However, due to the limitation of the retrospective nature of the current study, further clinical trials are required for confirmation.

中文翻译：

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放化疗对老年食管鳞状细胞癌患者有好处吗？多中心数据的倾向得分匹配分析（3JECROG R-03A）。

背景技术本研究的目的是评估老年食管鳞状细胞癌（ESCC）患者同时进行放化疗（CRT）或单独放疗（RT）的疗效。方法收集并回顾性分析单纯RT或CRT治疗的ESCC患者的临床资料。对1年，3年和5年总生存率（OS）以及与生存相关的临床特征进行统计分析。倾向得分匹配（PSM）分析用于补偿CRT和RT单独组之间基线特征的差异，以确认生存差异。结果共有729名患者符合纳入标准。糖尿病，原发肿瘤体积（pTV），原发肿瘤位置（pTLo），临床T期，（cT）临床N期（cN），临床M期（cM）和对RT的短期反应是影响OS的独立因素（P = 0.002-0.044）。在整个队列研究中，仅RT组和CRT组的5年OS率分别为26.6％，26.0％和30.1％。在PSM之前或之后，仅RT和CRT之间的生存期差异并不显着。与仅接受放疗的相应亚组相比，CRT显着使糖尿病患者（P = 0.003），cT4（P = 0.030）和cN0（P = 0.049）受益，而在其他亚组中，仅在CRT和RT之间未发现获益，包括cT1-3，cN1，cM，pTLo，pTV，年龄和性别。结论与单独使用RT相比，采用当前化疗方案的CRT可能无法提高老年ESCC患者的生存率，但cT4期，cN0期或糖尿病患者除外。然而，