Effectiveness of S-1-based chemoradiotherapy for esophageal squamous cell carcinoma in patients aged 70 years or older

Double-agent intravenous chemotherapy concurrent with radiotherapy is the standard of care for patients with inoperable esophageal cancer. However older patients tend to tolerate intravenous less well. A multicenter phase 3 trial in China compared oral S-1 chemotherapy with simultaneous integrated boost radiotherapy (CRTCT) versus RT alone for inoperable esophageal squamous cell carcinoma (ESCC) in patients aged 70 year or older. Three-years overall and progression-free survival in the CRTCT group were superior compared with the RT group, while the incidence of grade 3 to 5 toxic effects was similar in both groups. The authors conclude that oral S-1 chemotherapy with simultaneous integrated boost radiotherapy should be considered as an alternative treatment option for inoperable ESCC in patients aged 70 years or older (visual abstract).