Abstract
Objective:Definitive chemoradiotherapy(dCRT)is the standard treatment for unresectable locally advanced esophageal cancer.However,this treatment is associated with substantial toxicity,and most malnourished or elderly patients are unable to complete this therapy.Therefore,there is a need for a more suitable radiotherapy combination regimen for this population.This study was aimed to evaluate the efficacy and safety of a combination regimen comprising chemotherapy with nimotuzumab and S-1 and concurrent radiotherapy for patients with fragile locally advanced esophageal cancer with a high Nutritional Risk Screening 2002(NRS-2002)score.Methods:Eligible patients with unresectable esophageal carcinoma who had an NRS-2002 score of 2 or higher were enrolled.They were treated with S-1 and nimotuzumab with concurrent radiotherapy,followed by surgery or definitive radiotherapy.The primary endpoint was the locoregional control(LRC)rate.Results:A total of 5 5 patients who met the study criteria were enrolled.After completion of treatment,surgery was performed in 15 patients and radiotherapy was continued in 40 patients.The median follow-up period was 33.3[95％confidence interval(95％CI),31.4-35.1)]months.The LRC rate was 77.2％(95％CI,66.6％-89.4％)at 1 year in the entire population.The overall survival(OS)rate and event-free survival(EFS)rate were 57.5％and 51.5％at 3 years,respectively.Surgery was associated with better LRC[hazard ratio(HR)=0.16;95％CI,0.04-0.70;P=0.015],OS(HR=0.19;95％CI,0.04-0.80;P=0.024),and EFS(HR=0.25;95％CI,0.08-0.75;P=0.013).Most adverse events were of grade 1 or 2,and no severe adverse events occurred.Conclusions:For malnourished or elderly patients with locally advanced esophageal cancer,radiotherapy combined with nimotuzumab and S-1 is effective and has a good safety profile.
基金项目
Beijing Xisike Clinical Oncology Research Foundation(Y-Young2023-0114)
NETL
NSTL
万方数据