Keywords
Elderly
Volumetric modulated arc therapy
Raltitrexed
Submitted : 2025-07-09
Accepted : 2025-07-24
Published : 2025-08-08
Abstract
Objective: To investigate the efficacy and adverse reactions of volumetric modulated arc therapy (VMAT) radiotherapy combined with raltitrexed chemotherapy in the treatment of elderly patients with esophageal cancer. Methods: A total of 86 elderly patients with esophageal cancer admitted to our hospital between February 2024 and February 2025 were enrolled in this study and equally divided into two groups: a control group receiving VMAT radiotherapy alone and a study group receiving VMAT radiotherapy combined with raltitrexed chemotherapy, with 43 patients in each group, to compare the therapeutic outcomes between the two treatment approaches. Results: The study group demonstrated significantly higher objective remission and disease control rates than the control group (P < 0.05). Post-treatment levels of HSP90α, Cyfra21-1, and CEA were markedly reduced in the study group relative to the control group (P < 0.05). Adverse reaction incidence showed no notable difference between the two groups (P > 0.05). Quality of life (QOL) scores were significantly elevated in the study group compared to the control group at both 3- and 6-month follow-ups (P < 0.05). Conclusion: VMAT radiotherapy combined with raltitrexed chemotherapy can improve the short-term efficacy, reduce tumor marker levels, and improve the quality of life of elderly patients with esophageal cancer. The treatment has fewer adverse reactions and better patient tolerance.
References
Liu M, Yang W, Guo C, et al, 2024, Effectiveness of Endoscopic Screening on Esophageal Cancer Incidence and Mortality: A 9-Year Report of the Endoscopic Screening for Esophageal Cancer in China (ESECC) Randomized Trial. J Clin Oncol, 42(14): 1655–1664.
Feng Y, Long Y, Tan J, et al, 2024, Dosimetry Study of Double Arc and Dual Arc Techniques in VMAT Planning for Middle and Lower Esophageal Cancer. Medical and Health Equipment, 45(1): 62–66.
Dan Y, Sun X, Lin Y, 2024, Research Progress on Multidisciplinary Comprehensive Treatment of Unresectable Locally Advanced Esophageal Squamous Cell Carcinoma with Radiotherapy as the Main Treatment. Chinese Medical Journal, 104(30): 2865–2870.
National Health Commission of the People’s Republic of China, Medical Administration Bureau, 2022, Guidelines for the Diagnosis and Treatment of Esophageal Cancer (2022 Edition). Chinese Journal of Digestive Surgery, 21(10): 1247–1268.
Yi J, Wang L, 2003, Introduction to the Guiding Principles for Evaluating the Efficacy of Solid Tumors. Foreign Medical Sciences (Clinical Radiology Fascicle), 26(5): 330–332.
Ke J, Xie Y, Huang S, Wang W, Zhao Z, Lin W, 2024, Comparison of Esophageal Cancer Survival After Neoadjuvant Chemoradiotherapy Plus Surgery Versus Definitive Chemoradiotherapy: A Systematic Review and Meta-Analysis. Asian J Surg, 47(9): 3827–3840.
Yang H, Li P, Yuan Q, et al, 2024, Dosimetry Study of VMAT Technology Radiotherapy for Middle and Upper Esophageal Cancer in Different Respiratory Phases. Journal of North Sichuan Medical College, 39(2): 234–238.
Jiang C, Liang L, Gao X, et al, 2023, Application Effect of Spiral Tomography Radiotherapy in the Treatment of Lower Esophageal Cancer and Its Influence on Cardiopulmonary Function of Patients. Chinese Journal of Medical Physics, 40(03): 297–302.
Yan K, Wei W, Deng W, et al, 2023, Long-Term Prognosis Analysis and Influencing Factors of Radical Concurrent Chemoradiotherapy for Cervical and Upper Esophageal Squamous Cell Carcinoma. Chinese General Practice, 26(30): 3785–3790 + 3796.
Wang H, Hei Y, Sun M, et al, 2024, Efficacy of Bevacizumab Combined with Raltitrexed in the Treatment of Unresectable Hepatocellular Carcinoma and Its Effects on Adverse Reactions and Survival Rate. Journal of Practical Medicine, 40(21): 3061–3066.
Zeng Q, 2023, Study on the Efficacy and Safety of Intraoperative Intraperitoneal Injection of Raltitrexed Combined with Postoperative Chemotherapy in the Treatment of Elderly Patients with Advanced Gastric Cancer. Journal of Ningxia Medical University, 45(3): 290–294.