Affiliation:
1. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer
Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
2. Department of Radiation
Oncology, Cancer Hospital of HuanXing, Beijing, China
Abstract
Background:
Concurrent or definitive chemoradiotherapy is the standard treatment of locally
advanced esophageal squamous cell carcinoma (ESCC). Elderly patients could not tolerate the
standard concurrent chemotherapy and were treated with radiotherapy because of weak physical status
and multiple comorbidities.
Objective:
The efficacy and safety profile of concurrent (chemo) radiotherapy combined with
nimotuzumab in elderly patients with ESCC were investigated.
Methods:
Eligible elderly (≥70 years) patients with locally advanced ESCC were enrolled in this prospective,
real-world pragmatic study and received concurrent chemoradiotherapy or radiotherapy
combined with nimotuzumab. The primary endpoint was overall survival (OS). Secondary endpoints
were objective response rate, disease control rate, progression-free survival (PFS), and adverse drug
reactions.
Results:
Fifty-three elderly patients were enrolled. Thirty-two (60.4%) were treated with radiotherapy
combined with nimotuzumab (RT+N), and 21 (39.6%) with concurrent chemoradiotherapy combined
with nimotuzumab (CRT+N). The median age was 75.8 years. Fourteen (56.0%) patients achieved a
partial response, and 11 (44.0%) patients achieved stable disease at 3 months. The median follow-up
duration was 24.4 (95%CI, 21.6-26.7) months. Median OS (mOS) was 27.0 (95%CI, 14.8-48.4)
months. Median PFS (mPFS) was 22.6 (95%CI, 12.4-not reached) months. Higher mPFS (not reached
vs. 12.0 months; p=0.022) and mOS (48.4 vs. 15.3 months; p=0.009) were observed in the CRT+N
group compared with the RT+N group. Most adverse reactions were grade 1-2 (46, 86.8%).
Conclusions:
Concurrent chemoradiotherapy or radiotherapy combined with nimotuzumab was safe
and well-tolerated in elderly patients with locally advanced ESCC. ESCC patients treated with
CRT+N could live longer.
Funder
CAMS Innovation Fund for Medical Sciences
Foundation of the Chinese Society of Clinical Oncology
Publisher
Bentham Science Publishers Ltd.
Subject
Cancer Research,Drug Discovery,Pharmacology,Oncology
Reference34 articles.
1. Zhang S.; Sun K.; Zheng R.; Zeng H.; He J.; Carcinoma incidence and mortality in China, 2015. J. Nat. Cancer. Cent 2021,1(1),2-11
2. Zeng H.; Chen W.; Zheng R.; Zhang S.; Ji J.S.; Zou X.; Xia C.; Sun K.; Yang Z.; Li H.; Wang N.; Han R.; Liu S.; Li H.; Mu H.; He Y.; Xu Y.; Fu Z.; Zhou Y.; Jiang J.; Yang Y.; Chen J.; Wei K.; Fan D.; Wang J.; Fu F.; Zhao D.; Song G.; Chen J.; Jiang C.; Zhou X.; Gu X.; Jin F.; Li Q.; Li Y.; Wu T.; Yan C.; Dong J.; Hua Z.; Baade P.; Bray F.; Jemal A.; Yu X.Q.; He J.; Changing cancer survival in China during 2003-15: A pooled analysis of 17 population-based cancer registries. Lancet Glob Health 2018,6(5),e555-e567
3. Cao X.; Sun X.; Incidence and trend of esophageal carcinoma. Chin J Clin Oncol 2016,43(21),932-936
4. Feng R.M.; Zong Y.N.; Cao S.M.; Xu R.H.; Current cancer situation in China: Good or bad news from the 2018 Global Cancer Statistics? Cancer Commun 2019,39(1),22
5. Jiang D.; Li X.; Wang H.; Shi Y.; Xu C.; Lu S.; Huang J.; Xu Y.; Zeng H.; Su J.; Hou Y.; Tan L.; The prognostic value of EGFR overexpression and amplification in Esophageal squamous cell Carcinoma. BMC Cancer 2015,15(1),377