Docetaxel with concurrent radiotherapy safe in most elderly oesophageal cancer patients

Concurrent docetaxel with radiotherapy (DOC-RT) is generally safe in elderly patients with oesophageal cancer (EC), though caution should be advised in the very old and undernourished, a recent study has shown.

The study included 84 older EC patients (median age, 80 years; 84 percent male) who underwent radiotherapy at 60 Gy in 30 fractions. Participants also received concurrent DOC treatment at 10 mg/m2 per week for six cycles. Outcomes included survival, toxicity and treatment completion.

Over a median follow-up of 14 months, majority of the patients died. Forty deaths were attributable to tumour progression. The remaining 27 survivors were followed for a median of 24 months. The resulting 1-, 3- and 5-year progression-free survival (PFS) rates were 41 percent, 24 percent and 8 percent, respectively.

At the same time points, the corresponding overall survival (OS) estimates were 63 percent, 33 percent and 13 percent. The median survival time was 21 months.

Sixty-five participants completed DOC-RT, yielding a completion rate of 89 percent. Discontinuations were due to deterioration of general condition, oesophageal fistulae, pneumonia and pain. Noncompleters were significantly more likely to be very old (p<0.001), at least 80 years of age, and undernourished (p=0.004), with geriatric nutritional risk index scores <92.

None of the other baseline factors, including sex, clinical stage, smoking status and treatment factors, affected completion rate.