1Department of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, Zhengzhou 450008, China; 2Department of Thorax Surgery, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, Zhengzhou 450008, China
AbstractObjective To determine the treatment outcome of nimotuzumab in combination with neoadjuvant concurrent chemoradiotherapy followed by surgery for locally advanced esophageal squamous cell carcinoma (ESCC). Methods A total of 23 ESCC patients were enrolled. The preoperative strategies consisted of nimotuzumab (200 mg per week in week 1-5), concurrent chemotherapy by paclitaxel (45 mg/m2 per week in week 2-5) and cisplatin (20 mg/m2 per week in week 2-5) and radiotherapy by a total dose of 40 Gy (2. 0 Gy/d,5 days per week in week 2-5). Esophagectomy was performed 4 weeks after the completion of preoperative therapies. Results All of the 23 patients enrolled completed the planned combined therapy method, and 22 patients underwent final surgery. The clinical response rate of nimotuzumab in combination with preoperative chemoradiotherapy was 96%. The most frequent Grade 1/2 toxicities observed were gastrointestinal reaction, bone marrow suppression, and esophagitis. The rate of radical resection was 100%, and the pathological complete response rate was 41%.The incidence rate of postoperative pulmonary infection, anastomotic leak, hoarseness, and arrhythmia were 14%, 9%, 4%, and 4%, respectively. No perioperative deaths occurred in our study. The 1-, 3-, and 5-year overall survival (OS) rate for all the patients were 86%, 52% and 52%, respectively. The median survival time (MST) was 28.9 months. Postoperative pathologic results showed 15 patients with lymph node negative and 7 patients with lymph node positive. the 1-, 3-, and 5-year OS for pN0 group were 100%, 62% and 62%, versus 57%, 29% and 29% for pN+ group (P=0.033). The MST for pN0 group was 42.6 months versus 14.2 months for pN+ group. Conclusions The regimen of nimotuzumab in combination with preoperative concurrent chemoradiotherapy followed by surgery is safe and effective for locally advanced ESCC. Patients with lymph node negative after surgery have significantly improved long-term survival.
Corresponding Authors:
Wang Jianhua,Email:huanjianye@sina.cn
Cite this article:
Wu Xiaoyuan,Xing Wenqun,Li Xu et al. Preliminary clinical study of Nituzumab combined with neoadjuvant concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2019, 28(3): 185-187.
Wu Xiaoyuan,Xing Wenqun,Li Xu et al. Preliminary clinical study of Nituzumab combined with neoadjuvant concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2019, 28(3): 185-187.
[1] Berger A C, Farma J, Scott W J, et al. Complete response to neoadjuvant chemoradiotherapy in esophageal carcinoma is associated with significantly improved survival[J]. Journal of clinical oncology, 2005, 23(19):4330-4337. DOI:10.1200/JCO.2005.05.017。 [2] 吴小源,邢文群,刘劲松,等.局部进展期食管鳞癌术前同期放化疗的Ⅱ 期临床研究[J].中华放射肿瘤学杂志,2015,24(1):25-28.DOI:10.3760/cma.j.issn.1004-4221.2015.01.007. Wu XY,Xing WQ,Liu JS,et al. Clinical study of the Ⅱ stage of radiotherapy and chemotherapy for local progression esophageal squamous cell carcinoma in the same period[J].Chin J Radiat Oncol,2015,24(1):25-28.DOI:10.3760/cma.j.issn.1004-4221.2015.01.007. [3] 陈静,马林,曲宝林,等.尼妥珠单抗及西妥昔单抗增强照射对人食管癌细胞系的作用[J].中华放射医学与防护杂志,2014,34(7):489-492.DOI:10.3760/cma.j.issn.0254-5098.2014.07.003. Chen J,Ma L,Qu BL,et al. Effect of nituzumab and rituximab on the cell lines of human esophageal carcinoma[J].Chin J Radiol Med Protect,2014,34(7):489-492.DOI:10.3760/cma.j.issn.0254-5098.2014.07.003. [4] Philippron A,Bollschweiler E,Kunikata A,et al. Prognostic relevance of lymph node regression after neoadjuvant chemoradiation for esophageal cancer[J].Semin Thorac Cardiovascul Surg,2016,28(2):549-558.DOI:10.1053/j.semtcvs.2016.04.003. [5] 吴昌荣,薛恒川,朱宗海,等.现代二野淋巴结清扫食管癌切除术的疗效分析[J].中华肿瘤杂志,2009,31(8):630-633.DOI:10.3760/cma.j.issn.0253-3766.2009.08.015. Wu CR,Xue HC,Zhu ZH,et al. Efficacy analysis of modern wild lymph node dissection and esophageal carcinoma resection[J].Chin J Oncol,2009,31(8):630-633.DOI:10.3760/cma.j.issn.0253-3766.2009.08.015.
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