RT Journal Article
SR Electronic
T1 Impact of Frailty on Treatment Outcome in Patients With Locally Advanced Esophageal Cancer Undergoing Concurrent Chemoradiotherapy
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 5213
OP 5222
DO 10.21873/anticanres.15340
VO 41
IS 10
A1 YUNG-HSIN HUANG
A1 YU-SHIN HUNG
A1 CHENG-CHOU LAI
A1 MING-MO HO
A1 KUN-YUN YEH
A1 CHIEH YANG
A1 CHANG-HSIEN LU
A1 CHEN-KAN TSENG
A1 NGAN-MING TSANG
A1 CHIA-YEN HUNG
A1 SHUN-WEN HSUEH
A1 PEI-HUNG CHANG
A1 YA-WEN HO
A1 YU-CHING LIN
A1 WEN-CHI CHOU
YR 2021
UL http://ar.iiarjournals.org/content/41/10/5213.abstract
AB Background/Aim: The clinical significance of frailty status on treatment outcome in patients with esophageal cancer (EC) has been seldom explored. This study aimed to evaluate the impact of pretreatment frailty on treatment-related toxicity and survival outcome in patients with EC undergoing concurrent chemoradiotherapy (CCRT). Patients and Methods: Patients aged ≥20 years and with newly diagnosed locally advanced EC receiving neoadjuvant radiotherapy and concurrent chemotherapy with weekly administration of carboplatin and paclitaxel for 5 weeks were prospectively enrolled. A pretreatment frailty assessment was performed within 7 days before CCRT initiation. The primary endpoint was treatment-related toxicity and complications of CCRT while the secondary endpoint was overall survival. Results: A total of 87 patients were enrolled, 41 (47%) and 46 (53%) of whom were allocated in the frail and fit group, respectively. Frail patients had a significantly higher incidence of having at least one severe hematological adverse event (63.4% vs. 19.6%, p<0.001), higher risk of emergent room visiting [relative risk 3.72; 95% confidence interval (CI)=1.39-9.91; p=0.009] and hospitalization (relative risk 3.85; 95% CI=1.03-11.2; p=0.013) during the course of CCRT, when compared to fit patients. Overall survival showed significant worsening in the frail group [adjusted hazard ratio (HR)=2.12; 95% CI=1.01-4.42; p=0.046]. Conclusion: Frailty is associated with increase of treatment-related toxicities and poor survival outcome in EC patients undergoing CCRT. Our study suggested that pretreatment frailty assessment is imperative to serve as a predictor and prognostic factor for all adult patients with EC undergoing CCRT.