{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:26:14Z","timestamp":1787199974343,"version":"build-2736575974"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify prognostic factors in elderly squamous cell carcinoma (ESCC) patients receiving definitive chemoradiotherapy (dCRT) and construct a prognostic risk stratification model for identifying high-risk subgroups among elderly patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>ESCC patients aged \u2265ge years receiving dCRT were enrolled. Baseline Cumulative Illness Rating Scale-Geriatrics (CIRS-G), Geriatric Nutrition Risk Index (GNRI), Systemic Immune-Inflammation Index (SII), clinical characteristics and adverse events were collected. Cox regression identified independent prognostic factors, with proportional hazards assessed by Schoenfeld residual tests and 95% confidence intervals validated by 1000 bootstrap resamples. Restricted cubic spline (RCS) curves evaluated potential cutoff values. Survival was analyzed by Kaplan-Meier method and compared by log-rank test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>88 patients were enrolled. Multivariate analysis identified age (HR 1.047, 95% CI 1.000\u20131.095) and CIRS-G (HR 1.179, 95% CI 1.014\u20131.376) as independent predictors of OS, whereas GNRI (HR 0.964, 95% CI 0.932\u20130.995) independently predicted PFS. Schoenfeld tests confirmed proportional hazards (all P &amp;gt; 0.05), with bootstrap resampling supporting coefficient stability. Cutoffs were set at 75 years for age, 7 for CIRS-G, and 98 for GNRI. A prognostic score combining age and CIRS-G stratified patients into low-risk (0\u20131) and high-risk (2) groups, with high-risk patients showing significantly inferior OS. GNRI \u226598 correlated with prolonged PFS versus &amp;lt;98. The high-risk group had higher neutropenia\/leukopenia (15.0% vs. 6.3%) and pneumonitis (5.0% vs. 2.1%), with exclusive thrombocytopenia\/anemia (2.5% each).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A composite risk score (age \u226575 years plus CIRS-G \u22657) identified a high-risk subgroup with poor OS. The optimal therapeutic strategy for this subgroup warrants prospective interventional trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1898060","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:16:32Z","timestamp":1787199392000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Age and CIRS-G for risk stratification in elderly esophageal squamous cell carcinoma patients receiving definitive chemoradiotherapy"],"prefix":"10.3389","volume":"16","author":[{"given":"Mingyu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiation Therapy, The Second Affiliated Hospital of Xingtai Medical College","place":["Xingtai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, The Second Affiliated Hospital of Xingtai 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